Ergonovine Maleate and β-Blockers for Prinzmetal’s Angina
To the Editor:
I enjoyed reading the case report on Prinzmetal’s angina that appeared in a recent issue of the Journal.1 I reported a variant of Prinzmetal’s angina 27 years ago2 and continue to have an interest in the disease.
Until recently, I relied on ergonovine maleate as a provocative agent for coronary artery spasm in Prinzmetal’s angina and its variant.3 Unfortunately, ergonovine maleate (Ergotrate) is no longer commercially available in the United States.4 I wonder where Delacretaz et al1 obtained their supply of ergonovine maleate for their patient. This information would be very helpful to those of us who still like to use it in the cardiac catheterization laboratory to document or exclude coronary artery spasm.
I also noted that the patient received atenolol to control ventricular rate in the presence of atrial fibrillation. β-Blockers may exacerbate coronary vasospasm by increasing α-adrenergic activity.5 Therefore, I would be interested in learning how the patient is doing.
- Copyright © 2001 by American Heart Association
Delacretaz E, Kirshenbaum JM, Friedman PL. Prinzmetal’s angina. Circulation. 2000;101:e107–e108.
Cheng TO, Bashour T, Kelser GA Jr, et al. Variant angina of Prinzmetal with normal coronary arteriograms: a variant of the variant. Circulation. 1973;47:476–485.
Cheng TO, Yasue H. Coronary artery spasm. In: Cheng TO, ed. The International Textbook of Cardiology. New York: Pergamon; 1987:621–637.