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Value in the Diagnosis of Coronary Spasm

Joseph L. Gerry, MD; Stephen C. Achuff, MD; Lewis C. Becker, MD; Malcolm S. Pond, MD; H. Leon Greene, MD

JAMA. 1979;242(26):2858-2861.

Abstract
Thirty-five patients with atypical chest pain were given ergonovine maleate as a provocative test for coronary spasm. None of the patients had significant coronary atherosclerosis. The patients were divided into two groups based on clinical information available before ergonovine testing. Group 1 patients (n=13) had objective evidence of cardiac disease manifested by episodes of syncope, ventricular tachyarrhythmias, myocardial infarction, or transient ST segment shifts with chest pain. Group 2 patients had chest pain but no objective evidence of cardiac disease. The ergonovine test was positive in 11 of 13 patients in group 1. None of the 22 group 2 patients had a positive response to ergonovine. These data suggest that ergonovine testing does not allow for any more precise recognition of patients with atypical chest pain who have coronary artery spasm than do clinical data alone.

(JAMA 242:2858-2861, 1979)

Author Affiliations
From the Cardiovascular Division, Department of Medicine, The Johns Hopkins Medical Institutions, Baltimore.

Footnotes
Reprint requests to Carnegie 568, The Johns Hopkins Hospital, 601 N Broadway, Baltimore, MD 21205 (Dr Achuff).

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