Edrophonium, Ergonovine, and the Diagnosis of Chest Pain

Letters and Corrections1 December 1985Edrophonium, Ergonovine, and the Diagnosis of Chest PainDAVID L. OSHIN, M.D.DAVID L. OSHIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-103-6-958_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Noncardiac chest pain is indeed "a vexing diagnostic problem," as Richter and colleagues (1) note at the outset of their recent article on edrophonium provocation of esophageal chest pain. However, their conclusions regarding the superiority of edrophonium to ergonovine as a diagnostic agent in this setting are open to question.Ideally, any patient with chest pain suggestive of coronary artery disease significant enough to warrant coronary angiography should be administered ergonovine during angiography if no hemodynamically significant coronary obstructions or other findings sufficient to explain the symptoms are noted. Only if focal coronary artery spasm is excluded...References1. RICHTER J, HACKSHAW B, WU W, and CASTELL D. Edrophonium: a useful provocative test for esophageal chest pain. Ann Intern Med. 1985;103:14-21. LinkGoogle Scholar2. BUXTON A, GOLDBERG S, and HIRSHFELD J. Refractory ergonovine-induced coronary vasospasm: importance of intracoronary nitroglycerin. Am J Cardiol. 1980;46:329-34. CrossrefMedlineGoogle Scholar1. HEUPLER F. Provocative testing for coronary arterial spasm: risk, method and rationale. Am J Cardiol. 1980;46:335-7. CrossrefMedlineGoogle Scholar2. BERTRAND M, LABLANCHE J, and TILMANT P. Frequency of provoked coronary arterial spasm in 1089 consecutive patients undergoing coronary arteriography. Circulation. 1982;65:1299-1306. CrossrefMedlineGoogle Scholar3. MASSERI A and CHIERCHIA S. Coronary artery spasm: demonstration, definition, diagnosis, and consequences. Prog Cardiovasc Dis. 1982;25:169. CrossrefMedlineGoogle Scholar4. RICHTER J, HACKSHAW B, WU W, and CASTELL D. Edrophonium: a useful provocative test for esophageal chest pain. Ann Intern Med. 1985;103:14-21. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: DAVID L. OSHIN, M.D.Affiliations: Good Samaritan Hospital Suffern, NY 10901 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1985Volume 103, Issue 6_Part_1Page: 958-959KeywordsAngiographyCoronary arteriesIschemiaStable coronary artery disease ePublished: 1 December 2008 Issue Published: 1 December 1985 PDF downloadLoading ...