The Ergonovine Test for Coronary Insufficiency

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Abstract
Ergonovine maleate in doses ranging from 0.1 to 0.4 mg administered intravenously has been demonstrated to be a reliable and safe test for coronary insufficiency. In 500 patients with angina of effort, 405 or 81% gave a positive test. The test was negative in 125 controls. The action of ergonovine is due to local vasoconstriction of the coronary tree. In support of this is the rapid nullifying effect of nitroglycerin and the absence of appreciable blood pressure or pulse changes and the animal studies of Karp, Rinzler and Travell. Criteria for positivity consist of the appearance of chest pain alone (if it stimulated the patient''s original complaint and is promptly relieved by nitroglycerin) and/or ecg changes (S-T segment depression and/or T wave inversion). These changes are quickly reversed by nitroglycerin. There were no appreciable side effects except for occasional nausea or headache.