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Failure of intravascular ultrasound to identify the site of recurrent focal coronary spasm during stenting
  1. T Azeem,
  2. D Adlam,
  3. A Gershlick
  1. Department of Cardiology, Glenfield Hospital, Leicester, UK
  1. Correspondence to:
    Dr David Adlam
    Wellcome Trust Centre for Human Genetics, Roosvelt Drive, Oxford OX3 7BN, UK;


Focal coronary spasm is often associated with an area of mural plaque disease. This report describes a patient with recurrent severe coronary spasm unresponsive to medical treatment. Coronary arteriography and intravascular ultrasound identified a candidate area of minor coronary atheromatous disease but ergonovine provocation testing showed the spastic coronary segment to be distal to and distinct from this area. Coronary stenting of the site identified by ergonovine provocation testing was effective in relieving provoked and spontaneous spasm.

  • coronary artery spasm
  • coronary stent
  • intravascular ultrasound
  • ergonovine provocation testing

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