Non-invasive evaluation of coronary vasospasm using a combined hyperventilation and cold-pressure-test perfusion CMR protocol.

Coronary vasospasm is a severe vasoconstriction of an epicardial coronary artery, which may lead to myocardial ischemia and cause symptoms of angina. The gold-standard for diagnosing coronary vasospasm is to perform an intracoronary provocation test and to demonstrate the epicardial vasoconstriction by coronary angiography. We report the case of a patient with coronary vasospasm in whom we succeeded to non-invasively provoke and subsequently non-invasively demonstrate myocardial ischemia by perfusion cardiovascular magnetic resonance (CMR).