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Epicardial spasm of the left anterior descending coronary artery and focal spasm of the left circumflex coronary artery can be resolved by intracoronary administration of 0. 2 mg nitroglycerine. After NTG injection, ACh provocation testing was repeated to determine the potential protective effects of NTG. In this patient, there was no more epicardial spasm, indicating that NTG had a protective antispastic effect on the epicardial arteries. Patients with angina due to coronary artery spasm can be difficult to monitor, as pharmacologic drugs are often prescribed on a trial and error basis. We report in this case that we present a novel route toward a more personalized pharmaceutical therapy in coronary artery spasm using a new protocol for invasive coronary spasm testing, which may avoid ineffective treatment trials in such patients.
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