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Figure 1 Cineangiograms of focal coronary spasm occurring at the site of significant atherosclerosis (Patient No. 10). Left, coronary angiogram of the right coronary artery in left anterior oblique view shows severe coronary stenosis with a 75% reduction of lumen diameter in the midportion. Middle, results of the acetylcholine provocation test were positive with the lumen diameter decreasing from a 75% to a subtotal occlusion by the superimposed focal coronary spasm. Right, luminal dilatation of the right coronary artery with a residual fixed coronary lesion of approximately 50–75% stenosis was observed after the administration of intracoronary isosorbide dinitrate. Unfortunately, this patient died suddenly of his disease. Autopsy studies were conducted.
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