Related Experiment Video
Updated: Aug 4, 2025

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
Can Significant Coronary Artery Disease Coexist With Transient Takotsubo Cardiomyopathy, and How Does Spasm
Paolo Angelini1, Carlo Uribe1, Philip A Salem2
1Center for Clinical Research, Texas Heart Institute, Houston, Texas.
Abstract:
An 86-year-old woman being treated for metastatic breast cancer developed severe chest pain at rest during a follow-up visit at a hospital's outpatient oncology clinic. An electrocardiogram showed severe ST-segment elevation. The patient was given sublingual nitroglycerin and was transferred to the emergency department. Diagnostic coronary angiography revealed moderate coronary artery disease with calcific stenoses and transient spastic occlusion of the left anterior descending coronary artery. For this patient, sublingual nitroglycerin aborted the spastic event and apparent transient takotsubo cardiomyopathy. Chemotherapy can potentially cause endothelial dysfunction and increased coronary spasticity, which could result in takotsubo cardiomyopathy.
Related Concept Videos
Acute Coronary Syndrome I: Introduction
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
Acute Coronary Syndrome III: Diagnostic Studies
Coronary Artery Disease III: Clinical Manifestations
Acute Coronary Syndrome IV: Interprofessional Care
Acute Coronary Syndrome V: Nursing Management

