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Cardiovascular Imaging

Ergonovine test

an attempt to provoke spasm in susceptible coronary arteries by intravenous administration of increasing doses of ergonovine maleate. This ergot alkaloid stimulates alpha adrenergic and serotoninergic receptors producing vasoconstriction. It is usually administered in a dose of 0.050.40 mg. It produces coronary arterial spasm in arterial segments prone to develop spontaneous spasm as the cause of angina, usually variant or Prinzmetals variant angina. Spasm may be induced in an apparently normal artery or at the site of a fixed atherosclerotic stenosis. While this test is usually done during coronary angiography in order to document the spasm (Fig.1), it has also been applied in the coronary care unit where a positive test is indicated by the onset of angina and ST segment elevation. The induced spasm is reversed with intravenous or intracoronary injection of nitroglycerin.

CBH

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Fig.1

Selective right coronary arteriograms in the left anterior oblique projection show severe stenosis in the artery induced by ergonovine (ERG) (left) and resolution of the spasm after nitroglycerin (NTG) (right).
Ergonovine test, Fig.1