Acetylcholine-Induced Myocardial Ischemia Without Epicardial Coronary Artery Spasm: A Possible Vasospasm of Small Coronary Arteries—A Case Report

Abstract
Small-vessel vasospasm has been speculated upon as a possible cause of chest pain in patients with normal-appearing coronary angiograms. In this report, a patient who experienced typical chest pain during acetylcholine testing, which caused ST segment elevation without epicardial coronary spasm, is presented. This finding suggests that small-vessel vasospasm may be involved in the induction of myocardial ischemia in patients with normal epicardial coronary arteries.

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