Coronary artery spasm may be important in a number of cardiovascular disorders including exertional angina, Prinzmetal's angina, silent ischemia, myocardial infarction, and sudden cardiac death. Abnormalities of the autonomic nervous system may play an integral role. In a 62-year-old woman with recurrent episodes of nocturnal diaphoresis, intracoronary acetylcholine administration provoked near-total occlusion of the left anterior descending artery. Episodic parasympathetic outflow may be responsible for coronary artery spasm in some patients.
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