Tohoku University Graduate School of Medicine 1 article published in JoVE Medicine Measurement of Myocardial Lactate Production for Diagnosis of Coronary Microvascular Spasm Jun Takahashi1, Akira Suda1, Satoshi Yasuda1, Hiroaki Shimokawa1 1Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Myocardial lactate production (coronary arterial-venous difference in serum lactate level) during coronary spasm provocation testing is considered as a highly sensitive marker that reflects acetylcholine-induced myocardial ischemia due to microvascular spasm. This article presents the procedures to assess myocardial lactate production for the diagnosis of coronary microvascular spasm.