Positron emission tomography in the diagnosis of variant angina

The diagnosis of coronary vasospasm in chronic vasospastic angina is established by the history of typical nocturnal angina pectoris with rapid relief after sublingual nitroglycerin, concomitant ST-segment elevation on the electrocardiogram and a recent normal coronary angiogram, True vasospasm may subsequently be confirmed on a coronary angiogram, either spontaneously or by provokation with acethylcholine. The authors show a case of acute vasospasm induced by a cold presser test in a 40-year-old man who had onset variant angina, Transient reduction of regional myocardial perfusion, angina pectoris at rest, and ST-segment elevation solved after administration of nitroglycerin.