Diagnosis of coronary Spasm
To diagnose coronary spasm, you may need to wear an ambulatory monitor for up to 48 hours. The monitor records your heart’s electrical impulses, even during sleep. If you have chest pain in the middle of the night, for example, we may be able to see changes on the electrocardiogram (EKG) that indicate coronary spasm. However, not all patients show EKG changes during every episode.
To diagnose coronary spasm, doctors may prescribe a special type of stress test called an ergonovine stress test. Ergonovine is a drug that is injected through an IV, usually during a cardiac catheterization. It can trigger coronary spasm, usually within minutes, at which point the doctor visualizes the coronary arteries, and then injects another medication into the coronary artery to relieve the spasm. Your EKG is recorded before, during and after the test. If you have a coronary spasm, the doctor can see it on your EKG as well as an angiogram.
We began performing ergonovine tests for coronary spasm in the Cardiac Labs at Cleveland Clinic in 1973.