Translesional pressure and flow responses in a patient with a vasoactive and atherosclerotic coronary artery

Sympathetic stimulation produces characteristic changes in systemic and coronary hemodynamics which can be detected by pressure and flow velocity measurements in patients with coronary artery disease. In this particular patient with a highly reactive coronary vasculature in association with a fixed obstructive lesion, marked vasoreactivity produced striking differences in the resting translesional pressure gradient and flow velocity. Intracoronary nitroglycerin was immediately effective in relieving adverse vasoconstrictor tone. Studies of coronary hemodynamics during sympathetic stimulation in such patients will lead to improved understanding of the therapeutic modalities and associated interventional techniques to treat ischemic producing vasoreactive coronary arteries.