Ergonovine Stress Echocardiography for the Diagnosis of Vasospastic Angina

Abstract

Coronary artery spasm has been considered as one of the major mechanisms causing dynamic stenosis of epicardial coronary arteries, which can evoke acute myocardial ischemia (see Chap. 3). Vasospastic angina caused by coronary artery spasm has a wide clinical spectrum; one typical clinical manifestation is variant angina, and coronary vasospasm has been also documented to contri­bute to the development of unstable angina or acute myocardial infarction N. Classically, coronary artery spasm has been diagnosed by an invasive provoca­tive procedure during diagnostic coronary angiography. As various noninvasive diagnostic tests for fixed atherosclerotic stenosis of epicardial coronary arteries (exercise ECG, stress echocardiography, and nuclear tests) are being used in routine daily practice, it would be useful to establish a reliable, noninvasive, and safe diagnostic method to document coronary artery spasm in the management of patients with vasospastic angina.