Coronary angiography with an acetylcholine provocation test is useful for diagnosing vasospastic angina in patients with hypertrophic cardiomyopathy, where baseline ECG changes can obscure ischemic signs.
May support acetylcholine provocation testing for vasospastic angina in hypertrophic cardiomyopathy despite ECG confounders; hypothesis-generating and leaves open prospective validation.
As the chest symptoms and electrocardiographic changes of hypertrophic cardiomyopathy are occasionally very similar to those of angina pectoris, there are some difficulties in the diagnosis and treatment of cases of ischemic heart disease associated with hypertrophic cardiomyopathy. Here we report a case of vasospastic angina pectoris associated with hypertrophic cardiomyopathy diagnosed by coronary spasm provocation test performed by intracoronary administration of acetylcholine. In the treatment of such cases, beta blockers, which have the effect of decreasing the oxygen demand of the heart and the potential to induce coronary spasm, must be administered carefully.
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Nakahashi et al. (1995) studied this question.
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