Use of Ergonovine to Identify Esophageal Spasm in Patients with Chest Pain

Abstract

Ergonovine maleate was administered i.v. to 14 patients with chest pain resembling angina pectoris and to 4 healthy volunteers. Five of the patients experienced their typical chest pain after ergonovine, and manometric signs of esophageal spasm also developed. The remaining 9 patients and the 4 volunteers did not experience chest pain, but all subjects except 1 had some symptomatic response to ergonovine, including chest warmth or heaviness, headache, mild choking sensation, facial numbness, flushing or nausea. Two of the 9 patients and 1 of the 4 volunteers developed manometric signs of esophageal spasm after ergonovine but experienced no chest pain. I.v. ergonovine may be useful to identify esophageal spasm in selected patients with chest pain who have normal coronary arteries or in whom coronary artery disease is insufficient to explain symptoms. The potential risks of ergonovine do not justify its routine use as a provocative agent for esophageal spasm.