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Updated: Oct 26, 2025

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
White Clot Formation at Acetylcholine Testing: A Change of Heart in MINOCA?
Paolo Angelini1, Maria T Gamero2, Carlo Uribe1
1Department of Cardiology, Texas Heart Institute, Houston, Texas, USA.
Abstract:
Coronary intraluminal white clot formation, apparently in response to acetylcholine testing, may explain a woman's long-term history of daily chest pain and multiple myocardial infarctions. Acetylcholine testing reproduced chest pain and revealed luminal filling defects in multiple vessels; imaging showed fresh white platelet clots. Antiplatelet prasugrel has substantially suppressed her symptoms. (Level of Difficulty: Advanced.).
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