The spasm provocation test (SPT) is an important test in the diagnosis of vasospastic angina (VSA). In many cases, this test is performed as the gold standard test, and VSA is considered not present if the SPT is negative. However, some patients continue to experience chest symptoms despite a negative SPT. In this study, we report four cases in which SPT was repeated to evaluate chest symptoms despite the negative results of the first SPT. Two men in their 70s, one woman in her 60s, and one woman in her 70s, all with chest symptoms, underwent a second SPT at 4, 3, 2, and 3 years, respectively, after the first SPT, which was negative. Three patients had positive results in the second SPT (75%). In conclusion, even when SPT is negative, the diagnosis of VSA should be made with clinical symptoms in consideration. In some cases, a second SPT may be required to confirm the diagnosis of VSA.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368680 | PMC |
http://dx.doi.org/10.4330/wjc.v9.i3.289 | DOI Listing |
Background: A coronary function test (CFT) is the recommended diagnostic test to identify coronary vasomotor dysfunction as a cause of symptoms in patients with angina and nonobstructive coronary arteries (ANOCA). Acetylcholine is the commonly used pharmacological agent for spasm provocation. We aimed to investigate an association between severity of symptoms and provocative acetylcholine dose.
View Article and Find Full Text PDFCureus
November 2024
Department of Cardiology, Aizawa Hospital, Matsumoto, JPN.
This case report describes a 15-year-old boy who presented with vasospastic angina (VSA). His symptoms included chest and back pain, nausea, and respiratory distress. After undergoing diagnostic tests, including coronary angiography and an acetylcholine provocation test, the patient was diagnosed with VSA.
View Article and Find Full Text PDFCoron Artery Dis
December 2024
Department of Biomedical Laboratory Science, Honam University, Gwangju, Korea.
Background: Coronary artery spasm (CAS) is a cause of variant angina. However, the understanding of CAS patterns in the presence of mild-to-moderate coronary artery stenosis is limited. This study aimed to evaluate the incidence and patterns of CAS in patients with insignificant coronary artery stenosis using intracoronary acetylcholine (ACH) provocation test.
View Article and Find Full Text PDFDiagnostics (Basel)
November 2024
Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania.
Eur Cardiol
November 2024
Department of Cardiology and Angiology, Robert Bosch Hospital Stuttgart, Germany.
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