Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Does a Negative Ergonovine Provocation Test Truly Predict Freedom from Variant Angina?

  • Kim, Yun Gi (Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital) ;
  • Kim, Hyun Jin (Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital) ;
  • Choi, Won-Suk (Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital) ;
  • Im, Moon-Sun (Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital) ;
  • Yoon, Chang-Hwan (Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National University and Cardiovascular Center, Seoul National University Bundang Hospital) ;
  • Suh, Jung-Won (Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National University and Cardiovascular Center, Seoul National University Bundang Hospital) ;
  • Choi, Dong-Ju (Division of Cardiology, Department of Internal Medicine, College of Medicine, Seoul National University and Cardiovascular Center, Seoul National University Bundang Hospital)
  • Published : 2013.03.30
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Abstract

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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References

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