Value of noninvasive assessment of patients with atypical chest pain and suspected coronary spasm using ergonovine infusion and thallium-201 scintigraphy

Journal Article · Mon Oct 01 04:00:00 EDT 1984 · Am. J. Cardiol.; (United States)

DOI:https://doi.org/10.1016/S0002-9149(84)80201-5· OSTI ID:6000451

DiCarlo, Jr, L A; Botvinick, E H; Canhasi, B S; Schwartz, A S; Chatterjee, K

Twenty-six patients with known benign coronary anatomic characteristics and atypical chest pain syndromes were evaluated for the possibility of coronary spasm. Incremental intravenous ergonovine maleate infusions were administered, and thallium-201 scintigraphy was performed at the peak dosage and during recovery in the coronary care unit. With ergonovine therapy, 4 patients (16%) had chest pain associated with electrocardiographic (ECG) or scintigraphic changes. Nine patients (35%) had chest pain without associated ECG or scintigraphic changes, and 13 patients did not have chest pain in response to ergonovine administration, although 2 (8%) had ergonovine-induced scintigraphic defects. All 4 patients with ergonovine-induced chest pain and associated ECG or scintigraphic abnormalities had resolution or reduction of chest pain after medical treatment. However, 7 of the 9 patients with ergonovine-induced chest pain in the absence of ECG or scintigraphic abnormalities continued to have symptoms despite medical treatment a mean of 18 months later. In this limited study of a select group, bedside ergonovine provocation appeared safe. Many patients had chest pain, but few showed ECG or scintigraphic evidence of ischemia. Perfusion scintigraphy appears to have potential complementary value for the identification of an ischemic cardiac cause of atypical chest pain and provides a rationale for appropriate therapy.

• Research Organization: Moffitt Hospital, San Francisco, CA
• OSTI ID: 6000451
• Journal Information: Am. J. Cardiol.; (United States), Journal Name: Am. J. Cardiol.; (United States) Vol. 54:7; ISSN AJCDA
• Country of Publication: United States
• Language: English

Related Subjects

550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BETA DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
BODY AREAS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
CHEST
CORONARIES
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DIAGNOSTIC USES
DIAGRAMS
DISEASES
ELECTROCARDIOGRAMS
ELECTRON CAPTURE RADIOISOTOPES
HEART
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPES
LABELLED COMPOUNDS
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PAIN
PATIENTS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
SYMPTOMS
THALLIUM 201
THALLIUM ISOTOPES
TRACER TECHNIQUES
USES