Biphasic response of coronary arterial diameter to intracoronary ergonovine

Abstract

Summary: This report presents a case of paradoxical cornnary arterial dilation induced by intracoronary ergonovine. When compared with the control angiogram, the right coronary artery obviously dilated with selective, intracoronary administration of cumulative doses of 5 pg and 15 p g ergonovine without concomitant hemodynamic changes. Additional intracoronary infusion of 35 p g ergonovine into the right coronary artery inversely increased vascular tone of the vessel associated with a focal hyperconstriction. Such a biphasic response of arterial diameter to intracoronary ergonovine was also observed in the left coronary artery, but the degree of dilation was much smaller.

Overview of the pharmacological spasm provocation test: Comparisons between acetylcholine and ergonovine

“…According to the JCS guidelines, maximal ER dose is 20-60 mg in the RCA and LCA [13]. In Table 3, we showed that the intracoronary cumulative maximal ER dose was 50 mg in each coronary artery in the majority of past reports [26][27][28][29][30][31][32][33]. However, in some reports, the intracoronary cumulative ER dose on both coronary arteries was more than 50 mg [34][35][36].…”