Rubidium-82 Positron Emission Tomography with Intravenous Ergonovine to Diagnose Vasospastic Angina.

The gold standard to diagnose vasospastic angina is intracoronary reactivity testing which is performed selectively at dedicated centers. Non-invasive imaging with single-photon emission computerized tomography (SPECT) or echocardiography do not enable accurate localization of spasm or quantification of change in myocardial perfusion in response to an abnormal vasoreactivity. Rubidium-82 positron emission tomography myocardial perfusion imaging (82Rb PET-MPI) with intravenous ergonovine was used to diagnose refractory vasospastic angina in a patient with a complex ischemic syndrome, recent coronary stenting and persistent atypical angina despite maximal-tolerable doses of guideline-directed medical therapy.