Left coronary arteriogram (angiogram, 45 degrees LAD view with 25 degrees
craniocudal angulation) of a 47-year-old man with active variant angina.
A 40% proximal LAD stenosis is present. The coronary arteries are otherwise
B. The control angina and ST (EKG)
elevation developed spontaneously during coronary arteriography. Repeat
injections reveal severe focal spasm at the site of the lesion. The
coronary spasm (see definition of vaso spasm) resolved immediately after
nitroglycerin (medication) administration.
C. Left coronary arteriogram in
the RAO view after ergonovine (medication) administration. Severe coronary
spasm is present both at the site of the LAD stenosis and distal to
D. Resolution of ergonovine-induced
spasm following nitroglycerin administration.
P., M.D., Waters, D., M.D., Diagnosis and Management of Patients with
Unstable Angina, The Hurst's The Heart, 8th ed., p 1099. (modified)