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KMID : 0368120130430030199
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Korean Circulation Journal
2013 Volume.43 No. 3 p.199 ~ p.203
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Does a Negative Ergonovine Provocation Test Truly Predict Freedom from Variant Angina?
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Kim Yun-Gi
Kim Hyun-Jin
Choi Won-Suk
Im Moon-sun
Yoon Chang-Hwan
Suh Jung-Won
Choi Dong-Ju
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Abstract
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Ergonovine provocation test is known to be very sensitive for diagnosing variant angina. The patient described in this study initially presented with atypical chest pain and underwent coronary angiography and ergonovine provocation tests, which were negative. The patient was subsequently prescribed a proton pump inhibitor and prokinetics for pain relief, but then presented with acute myocardial infarction and cardiogenic shock due to coronary artery vasospasm 5 years later. This case suggests that ergonovine provocation test generates false negative results, which can lead to unwanted outcomes. Even with a negative ergonovine provocation test, prescription of calcium channel blockers or nitrates should be considered in patients with a clinical history suggestive of variant angina.
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KEYWORD
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Angina pectoris, variant, Ergonovine, Coronary vasospasm
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