Performance of Ergonovine Provocative Testing for Coronary Artery Spasm

Position Papers1 January 1984Performance of Ergonovine Provocative Testing for Coronary Artery SpasmHEALTH AND PUBLIC POLICY COMMITTEEHEALTH AND PUBLIC POLICY COMMITTEESearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-100-1-151 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptErgonovine provocative testing for coronary artery spasm involves intravenous infusion of ergonovine maleate (under carefully controlled circumstances) in an attempt to provoke coronary artery spasm during the evaluation of possible variant angina. A classic positive response consists of coronary arterial spasm accompanied by the elevation of at least one ST segment on the scalar electrocardiogram (1, 2). However, spasm shown by angiography can occur without accompanying ST segment elevation, and ST segment elevation may not always be accompanied by coronary artery spasm.SafetyErgonovine provocative testing appears to be safe in patients who have neither variant angina nor fixed coronary...References1. NELSONNOWAKCHILDSWEINRAUCHFORWAND CBHLS. Provocative testing for coronary arterial spasm: rationale, risk and clinical illustrations. Am J Cardiol. 1977;40:624-9. CrossrefMedlineGoogle Scholar2. FESTER A. Ergonovine maleate—a provocative test. Cathet Cardiovasc Diagn. 1980;6:217-23. CrossrefMedlineGoogle Scholar3. BUXTONGOLDBERGHIRSHFELD ASJ. Refractory ergonovine-induced coronary vasospasm: importance of intracoronary nitroglycerin. Am J Cardiol. 1980;46:329-34. CrossrefMedlineGoogle Scholar4. PEPINEFELDMANCONTI CRC. Action of intracoronary nitroglycerin in refractory coronary artery spasm. Circulation. 1982;65:411-4. CrossrefMedlineGoogle Scholar5. WATERSSZLACHCICTHEROUXDAUWEMIZGALA DJPFH. Ergonovine testing in a coronary care unit. Am J Cardiol. 1980;46:922-30. CrossrefMedlineGoogle Scholar6. MASERICHIERCHIA AS. Review on coronary spasm. Prog Cardiovasc Dis. 1982;25:169-92. CrossrefMedlineGoogle Scholar7. GINSBURGLAMBBRISTOW RIM. Application and safety of outpatient ergonovine testing in accurately detecting coronary spasm in patients with possible variant angina. Am Heart J. 1981;102:698-702. CrossrefMedlineGoogle Scholar8. WHITTLEFELDMANPEPINE JRC. Variability of electrocardiographic responses to repeated ergonovine provocation in variant angina with coronary artery spasm. Am Heart J. 1982;103:161-7. CrossrefMedlineGoogle Scholar9. MAGDERJOHNSTONEHUCKELLADELMAN SDVA. Experience with ergonovine provocative testing for coronary artery spasm. Chest. 1981:79:638-46. CrossrefMedlineGoogle Scholar10. SCHROEDERBOLENQUINT JJR. Provocation of coronary spasm with ergonovine maleate. Am J Cardiol. 1977;40:487-91. CrossrefMedlineGoogle Scholar11. BERTRANDLABLANCHETILMANT MJP. Frequency of provoked coronary arterial spasm in 1089 consecutive patients undergoing coronary arteriography. Circulation. 1982;65:1299-1306. CrossrefMedlineGoogle Scholar12. PEPINEFELDMANCONTI CRC. Recommendations for use of ergonovine to provoke coronary artery spasm. Cathet Cardiovasc Diagn. 1980;6:423-6. CrossrefMedlineGoogle Scholar13. BRAUNWALD E. Mechanism of action of calcium-channel-blocking agents. N Engl J Med. 1982;307:1618-27. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: AMERICAN COLLEGE OF PHYSICIANS Philadelphia, Pennsylvania*This paper was authored by J. Sanford Schwartz, M.D., and Lisa Kaufmann, M.D., and developed for the Health and Public Policy Committee by the Clinical Efficacy Assessment Subcommittee: Donald E. Olson, M.D., Chairman; David Banta, M. D.; Alvan R. Feinstein, M.D.; Howard S. Frazier, M.D.; Richard B. Hornick, M.D.; and Seymour Perry, M.D. drafted the paper. Members of the Health and Public Policy Committee for the 1983-1984 term were Edwin P. Maynard, III, M.D., Chairman; Arthur J. Atkinson, Jr., M.D.; Steven C. Beering, M.D.; Richard G. Farmer, M.D.; Paul F. Griner, M.D.; John R. Hogness, M.D.; Charles E. Lewis, M.D.; Donald E. Olson, M.D.; Malcolm L. Peterson, M.D.; Theodore B. Schwartz, M.D.; and Helen L. Smits, M.D. Richard J. Reitemeier, M.D., and Francis J. Sweeney, Jr., M.D., were ex officio members. This position paper was adopted by the Executive Committee of the Board of Regents on 28 September 1983. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byReversible Cardiac Arrest Related to Late-Onset Coronary Spasm After a Positive Ergonovine TestErgonovine maleate testing during cardiac catheterization: A 10-year perspective in 3,447 patients without significant coronary artery disease or Prinzmetal's variant anginaReplyVariant angina in an 11 year old boyThe Clinical Efficacy Assessment Project of the American Collegeof Physicians 1 January 1984Volume 100, Issue 1Page: 151-152KeywordsAnginaAngiographyCoronary arteriesElectrocardiographyPrevention, policy, and public healthPublic policySafetySub-specialty care ePublished: 1 December 2008 Issue Published: 1 January 1984 Copyright & Permissions© 1984 American College of PhysiciansPDF downloadLoading ...