Is there a definitive test for coronary artery spasm?
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Provocative testing using intracoronary acetylcholine or ergonovine causes clinically significant coronary artery spasm in susceptible individuals. (SOR: B, based on a retrospective cohort study.) Hyperventilation, coldpressor stress echocardiography compares favorably with intracoronary acetylcholine in inducing spasm. (SOR: B, based on a prospective cohort study.) Patients with chest pain who are identified at risk for spasm should receive further evaluation by noninvasive methods, or if coronary catheterization is planned for suspected coronary artery disease (CAD), by invasive methods. (SOR: C, based on consensus guidelines.)
Evidence Based Practice 15(6): 09-10.