Ergonovine maleate test in various anginal syndromes

The ergonovine maleate (EM) test has been performed in fourgroups of 10 patients each: (A) variant angina; (B) angina atrest with ST segment depression during pain; (C) effort angina;(D) atypical chest i pain. EM was injected i.v. (highest dose 0-4 mg) first in the CoronaryCare Unit and thereafter during coronary angiography. EM causedcoronary spasm with angina and ST segment elevation in everypatient of group A and in one patient of group B. In five and four patients of groups B and C, respectively, EMinduced angina and ST segment depression without any localizedcoronary spasm, the coronary angiography showing only a diffusenarrowing of the coronary vessels; these patients had the lowesteffort tolerance and the most severe coronary lesions. Spontaneous or induced coronary spasm in patients with anginaat rest and ST segment depression during chest pain did notoccur in this study. An increase of the peripheral and/or coronaryresistances due to EM could be the mechanism of the ischemicattack in patients with severe coronary lesions.