title: Role of vasospasm in acute coronary syndrome: insights from ergonovine stress echocardiography.
abstract: BACKGROUND
  Previous studies have shown that ergonovine stress echocardiography (ESE) may be a valuable noninvasive tool for the diagnosis of vasospasm after the confirmation of no significant fixed stenosis.
  
  
  RESULTS
  From May 1999 to January 2002, 52 patients who presented with acute coronary syndrome (ACS) and had normal or near-normal coronary angiograms were enrolled. A 50 microg bolus of ergonovine was given intravenously at 5-min intervals, until a positive result was observed or a total dose of 350 microg was given. After the ergonovine injection, positive results were found in 25 (48%) of 52 patients: 5 (26%) of 19 with unstable angina, 10 (53%) of 19 non-ST elevation myocardial infarction (MI) and 10 (71%) of 14 patients with ST elevation MI. Using univariate analysis, the elevation of troponin concentration, clinical diagnosis of MI, and ST segment elevation on initial electrocardiographic were significantly associated with positive stress test results.
  
  
  CONCLUSIONS
  Despite the limitation that coronary spasm was not confirmed angiographically with ergonovine provocation, ESE may be a useful technique for the noninvasive diagnosis of vasospasm.
authors.affiliation: Section of Cardiology, Dong-A Medical College, Busan, South Korea. kmh60@damc.or.kr
authors.forename: Moo Hyun
authors.initials: MH
authors.lastname: Kim
authors.forename: En Hee
authors.initials: EH
authors.lastname: Park
authors.forename: Doo Kyung
authors.initials: DK
authors.lastname: Yang
authors.forename: Tae Ho
authors.initials: TH
authors.lastname: Park
authors.forename: Sang Gon
authors.initials: SG
authors.lastname: Kim
authors.forename: Jin Hyuk
authors.initials: JH
authors.lastname: Yoon
authors.forename: Kwang Soo
authors.initials: KS
authors.lastname: Cha
authors.forename: Dong Sung
authors.initials: DS
authors.lastname: Kum
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jong Seong
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D002637:Chest Pain / Q000453:epidemiology; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D025401:Echocardiography, Stress / Q000379:methods*; D004874:Ergonovine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007564:Japan; D008297:Male; D008875:Middle Aged; D010120:Oxytocics / Q000008:administration & dosage; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking
chemical_list: D010120:Oxytocics; D004874:Ergonovine