Heart Arrest Caused by Ergonovine Stress Echocardiography

Park, Tae Ho; Kim, Moo Hyun; Jang, Se Jun; Kim, Seong Geun; Yang, Doo Kyung; Oh, Ill Hwan; Soo, Kwang; Kim, Jong Seong

doi:10.4070/kcj.2002.32.4.359

Cited by 1 publication

(1 citation statement)

References 12 publications

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“…Previous studies have shown that ergonovine echocardiography can diagnose coronary vasospasm before angiography, with a sensitivity of 91% and specificity of 88%, with it being a safe and reliable diagnostic screening test for VSA [16,17]. However, ergonovine stress echocardiography requires a non-invasive treadmill test or nuclear myocardial scan to pre-exclude significant coronary stenosis [18], and there has also been a case report of cardiac arrest during ESE, which was recovered after cardiopulmonary resuscitation (CPR) [19]. Although rare, caution and close monitoring throughout the procedure is required.…”

Section: Discussionmentioning

confidence: 99%

Role of Dual-Acquisition Noninvasive Cardiac CT Imaging for the Detection of Vasospastic Angina

Jin

Kang

Jin

et al. 2023

JCM

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Background: Vasospastic angina (VSA) is characterized by chest pain at rest with transient ischemic electrocardiographic changes in the ST segment, and a prompt response to nitrates. Vasospastic angina is among the most frequent of the coronary artery diseases in Asia, and coronary computed tomography angiography (CCTA) may become available as a non-invasive diagnosis method. Methods: We prospectively enrolled 100 patients with suspected vasospastic angina at two centers from 2018 to 2020. All patients underwent baseline CCTA without a vasodilator in the early morning followed by catheterized coronary angiography and spasm testing. CCTA with intravenous infusion of nitrate (IV) was repeated within 2 weeks of baseline CCTA. Vasospastic angina as detected by CCTA was defined as significant stenosis (≥50%) with negative remodeling without definite plaques or diffuse small diameter (<2 mm) of a major coronary artery with a beaded appearance on baseline CT that completely dilated on IV nitrate CT. We analyzed diagnostic performance of dual-acquisition CCTA for the detection of vasospastic angina. Results: The patients were categorized into three groups according to their provocation test result (negative, n = 36; probable positive, n = 18; positive, n = 31). The diagnostic accuracy in terms of CCTA per patient had a sensitivity of 55% (95% CI, 40–69), specificity of 89% (95% CI, 74–97), positive predictive value (PPV) of 87% (95% CI, 72–95), and negative predictive value (NPV) of 59% (95% CI, 51–67). Conclusions: Dual-acquisition CCTA can support the non-invasive detection of vasospastic angina with relatively good specificity and PPV. CCTA was helpful for non-invasive screening of variant angina.

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