Summary: To assess the local and systemic intracoronaq (IC) ergonovine maleate (EM), single or repeated 25 pg bolus injections were administered to 108 consecutive patients with chest pain and normal coronary arteriograms. Coronary artery spasm (CAS) was induced in 17 (15.7%) patients. None of these patients developed ST-segment depression, and ST-segment elevation appeared in only 6 (35.3%). In 59 of the 91 patients without CAS, both the IC and the intravenous (IV) EM arteriographic and hernodynamic effects were compared. The mean diameter of the vessels was reduced by 15% (p <0.001) after two single 25 pg ICEM injections. Only insignificant changes were induced in the heart rate (baseline 80f15; after ICEM 79 f 15 beatdmin; p = NS) and systolic aortic pressure (baseline 147k27; after ICEM 149f28 mmHG; p=NS). Following 350 pg of cumulative IVEM, the mean coronary diameter decreased by 20% (p