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Related Experiment Videos

Methergin testing with angiographically normal coronary arteries.

M Bory1, P Joly, J L Bonnet

  • 1Department of Cardiology, Centre Hospitalier Universitaire Timone, Marseille, France.

The American Journal of Cardiology
|February 1, 1988
PubMed
Summary

Coronary artery spasm occurred in 11% of patients with normal or minimally narrowed arteries. Autonomic nervous system blockade increased spasm incidence, particularly in those with atypical chest pain.

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Area of Science:

  • Cardiology
  • Clinical Medicine

Background:

  • Coronary artery spasm is a significant cause of chest pain, even in patients with non-obstructive coronary artery disease.
  • Understanding the incidence and triggers of spasm is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To determine the incidence of coronary artery spasm in patients with angiographically normal or non-obstructive coronary arteries (stenosis ≤50%).
  • To investigate the effect of cardiac autonomic nervous system blockade on spasm incidence.

Main Methods:

  • Methergin testing was performed in 1,200 patients undergoing coronary angiography.
  • A subset of 291 patients underwent repeat testing after autonomic blockade with atropine and labetolol.

Main Results:

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  • The overall incidence of positive methergin tests (indicating spasm) was 11% in the study population.
  • Spasm incidence varied by clinical presentation, being highest in angina at rest (54%) and Prinzmetal's angina (57%).
  • Autonomic blockade significantly increased the frequency of positive methergin tests from 8% to 19% (p<0.01), notably in patients with atypical chest pain (6% to 14%).

Conclusions:

  • Coronary artery spasm is present in 11% of patients with normal or non-obstructive coronary arteries.
  • Cardiac autonomic nervous system activity influences the manifestation of coronary artery spasm.
  • These findings highlight the importance of considering spasm in patients with chest pain and non-obstructive coronary artery disease.