Vasospastic angina, also described as Prinzmetal angina, was first described as a variant form of angina at rest with transient ST-segment elevation; it is common and present in many clinical scenarios, including chronic and acute coronary syndromes, sudden cardiac death, arrhythmia and syncope. However, vasospastic angina remains underdiagnosed, and provocative tests are rarely performed. The gold-standard diagnostic approach uses invasive coronary angiography to induce coronary spasm using ergonovine, methylergonovine or acetylcholine as provocative stimuli. The lack of uniform protocol decreases the use and performance of these tests, accounting for vasospastic angina underestimation. This position paper from the French Coronary Atheroma and Interventional Cardiology Group (GACI) aims to review the indications for provocative tests, the testing conditions, drug protocols and positivity criteria.

血管痉挛性心绞痛，也称为 Prinzmetal 心绞痛，最初被描述为静息时心绞痛的一种变异形式，伴有短暂性 ST 段抬高；它很常见并存在于许多临床情况中，包括慢性和急性冠状动脉综合征、心源性猝死、心律失常和晕厥。然而，血管痉挛性心绞痛仍然未被充分诊断，并且很少进行激发试验。金标准诊断方法使用侵入性冠状动脉造影，使用麦角新碱、甲基麦角新碱或乙酰胆碱作为激发刺激物来诱导冠状动脉痉挛。缺乏统一的方案降低了这些测试的使用和性能，导致血管痉挛性心绞痛的低估。法国冠状动脉粥样硬化和介入心脏病学小组 (GACI) 的这份立场文件旨在审查激发试验的适应症、试验条件、药物方案和阳性标准。