Acetylcholine-induced myocardial ischemia without epicardial coronary artery spasm: a possible vasospasm of small coronary arteries--a case report.
Small-vessel vasospasm has been speculated upon as a possible cause of chest pain in patients with normal-appearing coronary angiograms. In this report, a patient who experienced typical chest pain during acetylcholine testing, which caused ST segment elevation without epicardial coronary spasm, is presented. This finding suggests that small-vessel vasospasm may be involved in the induction of myocardial ischemia in patients with normal epicardial coronary arteries.
Sekiya
M
M
Second Department of Internal Medicine, Ehime University School of Medicine, Japan.
Okayama
H
H
Suzuki
M
M
Kobayashi
T
T
Matsuoka
H
H
Sumimoto
T
T
Hamada
M
M
Hiwada
K
K
D000109:Acetylcholine / Q000009:adverse effects*; D002637:Chest Pain / Q000139:chemically induced*; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000139:chemically induced* / Q000150:complications / Q000000981:diagnostic imaging
D000109:Acetylcholine