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Acetylcholine-Induced Myocardial Ischemia Without Epicardial Coronary Artery Spasm: A Possible Vasospasm of Small Coronary Arteries—A Case Report

The Second Department of Internal Medicine, Ehime University School of Medicine, Onsengun, Ehime, Japan

Hideki Okayama, M.D.

The Second Department of Internal Medicine, Ehime University School of Medicine, Onsengun, Ehime, Japan

Makoto Suzuki, M.D.

The Second Department of Internal Medicine, Ehime University School of Medicine, Onsengun, Ehime, Japan

Takamasa Kobayashi, M.D.

The Second Department of Internal Medicine, Ehime University School of Medicine, Onsengun, Ehime, Japan

Hiroshi Matsuoka, M.D.

The Second Department of Internal Medicine, Ehime University School of Medicine, Onsengun, Ehime, Japan

Takumi Sumimoto, M.D.

The Second Department of Internal Medicine, Ehime University School of Medicine, Onsengun, Ehime, Japan

Mareomi Hamada, M.D., F.A.C.A.

The Second Department of Internal Medicine, Ehime University School of Medicine, Onsengun, Ehime, Japan

Kunio Hiwada, M.D., F.A.C.A.

The Second Department of Internal Medicine, Ehime University School of Medicine, Onsengun, Ehime, Japan

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.

Angiology, Vol. 44, No. 10, 811-815 (1993)
DOI: 10.1177/000331979304401008


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