Coronary spasm: It’s common, but it’s still unsolved

Figure 1 A representative case with coronary spasm and coronary stenosis. The patient, who had chest symptoms for 20 min at rest, accompanied with cold sweating, was admitted to our institution for the evaluation of his chest symptoms. A: Coronary angiography showed coronary stenosis at the distal segment of the left circumflex coronary artery, which cannot be considered as the cause of his chest symptoms; B: The spasm provocation test using 100 µg of acetylcholine showed diffuse coronary spasm throughout the left anterior descending coronary artery, accompanied with usual chest pain, which had been restored after nitroglycerin injection. Coronary stenosis and spastic segments were indicated by bold arrow and plain arrows, respectively.