To evaluate the value of adenosine triphosphate stress contrast echocardiography in the diagnosis of coronary artery spasm.

Five typical cases of coronary artery spasm diagnosed by adenosine triphosphate stress contrast echocardiography and coronary angiography at Dongguan Kanghua Hospital from 2019 to 2020 were collected. The clinical features, the characteristics of coronary angiography, the dose usage of adenosine triphosphate during stress contrast echocardiography, and the characteristics of ventricular wall motion and myocardial perfusion in the presence of positive results were summarized and analyzed. The application of adenosine triphosphate stress contrast echocardiography in the diagnosis of coronary artery spasm was summarized.

Among the five patients, the maximum tolerated dose was 240 μg/(kg·min) in four cases and 220 μg/(kg·min) in one. The former four patients showed positive reaction 9~11 min after drug withdrawal, while the latter one showed positive reaction only 3 min after drug withdrawal. The maximum number of the involved segments of the left ventricular wall were six (case 1), and at least three segments were involved (cases 2 and 3). Coronary angiography revealed mild stenosis in all the five cases. The consistency between stress contrast echocardiography and coronary angiography was high in two cases, normal in two, and poor in one. Segmental motion and perfusion abnormalities caused by coronary spasm occurring in all the five patients appeared in the recovery period of stress contrast echocardiography test. Abnormal myocardial perfusion and wall motion preceded electrocardiogram ST-T changes and angina pectoris symptoms. None of the five patients had chest pain during the examination.

Adenosine triphosphate stress contrast echocardiography can be used to screen patients with variant angina pectoris by inducing coronary spasm. Under the condition of contrast echocardiography, myocardial motion and endocardial perfusion abnormalities can be well observed. As long as the abnormal myocardial motion can be detected early and the drug can be stopped in time, the safety and effectiveness of the examination can be ensured.