We could detect recruitable backward collateral how in systole and dia
stole by using a Doppler guide wire during coronary artery spasm in a
42-year-old female among 20 patients with documented variant angina, T
he electrocardiogram (EGG) showed no ST-segment deviation, although sh
e had chest pain and her coronary angiography showed a totally occlude
d right coronary artery. After administration of isosorbide dinitrate
(ISDN) the collateral flow disappeared and the flow pattern recovered
to normal, The good collateral flow pattern in patient with totally oc
cluded coronary artery due to spasm was indicated to relieve myocardia
l ischemia, even when the patient felt chest pain.