title: Acetylcholine-induced myocardial ischemia without epicardial coronary artery spasm: a possible vasospasm of small coronary arteries--a case report.
abstract: 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.
authors.affiliation: Second Department of Internal Medicine, Ehime University School of Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Sekiya
authors.forename: H
authors.initials: H
authors.lastname: Okayama
authors.forename: M
authors.initials: M
authors.lastname: Suzuki
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: H
authors.initials: H
authors.lastname: Matsuoka
authors.forename: T
authors.initials: T
authors.lastname: Sumimoto
authors.forename: M
authors.initials: M
authors.lastname: Hamada
authors.forename: K
authors.initials: K
authors.lastname: Hiwada
mesh_terms: 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
chemical_list: D000109:Acetylcholine