We reported a patient with chest pain, but the coronary angiography was normal. ATP stress myocardial contrast electrocardiography(MCE) was performed. There was apical ventricular septal perfusion delay before ATP stress, and the perfusion delay areas were significantly reduced at the peak period, which was similar to the “reverse redistribution” perfusion characteristics of nuclear myocardium in coronary vasospasm, The areas of delayed perfusion in the recovery period were larger than that before stress, the increase of blood flow spectrum resistance in the distal segment of left anterior descending coronary artery and the occurrence of chest pain all showed that ATP induced myocardial microvascular spasm. The MCE perfusion characteristics and the changes of coronary spectrum had certain clinical value in the diagnosis of myocardial microvascular spasm.

We report a case of coronary microvascular spasm assessed by ATP stress MCE (myocardial contrast electrocardiography). The patient had chest pain, but the coronary angiography was normal. There was apical ventricular septal perfusion delay before ATP stress, and the perfusion was significantly improved at peak stress, which was similar to the radionuclide myocardial perfusion characteristics of coronary microvascular spasm, In the recovery period, the flow spectrum resistance of the distal coronary artery of the left anterior descending artery increased compared with that before stress, which further confirmed that local coronary microvascular spasm was induced after vasodilation.