Surgical treatment of variant angina with positive cold pressor test

Coronary artery spasm is provoked by exercise, cold pressor test and pharmacological agents during cardiac catheterization. We describe a patient in whom the coronary artery was excessively sensitive to cold pressor test, and who was treated by coronary artery bypass grafting (CABG) combined with cardiac denervation. Postoperative coronary arteriogram showed decreased sensitivity to cold pressor test with patent graft. These observations suggest that combined CABG with cardiac denervation is indicated for patients with fixed organic coronary artery narrowing and positive provocative test, and that postoperative cold pressor test during coronary arteriography is a useful, low risk method for the evaluation of the efficacy of cardiac plexectomy.