Follow-up Provocation Test in Patients with Coronary Artery Spasm

ABSTRACT

BACKGROUND: Recurrent or persistent angina in patients with coronary artery spasm is relatively common, despite antianginal medication, however, its exact cause of chest pain remains elucidated. METHODS: In order to evaluate the role of persistent coronary artery spasm in such patients, 18 patients(M F=14 4, age 38-71 yrs) with coronary arteriographically proven coronary arterial spasm received follow-up coronary arteiography and same provocational test using intravenous ergonovine, intracoronary acetylcholine or intracoronary ergonovine administration. RESULTS: Upon follow-up provocation test, coronary artery spasm was demonstrated only at the same site as before in 10 patients(56%), at the same site as well as another different site in 3 patients(17%), and only at different site site in 3 patients(17%). In one patient, coronary artery spasm couldn't be provoked upon follow-up provocation test. Progression of coronary artery disease were found in 5 patients(28%) ; at same site as that of spasm in 2 patients and at different site in 3 patients. CONCLUSION: In patients with angiographically proven vasospastic angina, recurrence of anginal pain seems to be attributed mostly to the recurrence of the coronary artery spasm at consistent location and partly to newly developed fixed coronary artery stenoses.