Anzai H, Momiyama Y, Kimura M
Division of Internal Medicine, Tokyo Saiseikai Central Hospital.
J Cardiol. 1999 Aug;34(2):85-91.
A 63-year-old woman with abnormal Q waves in leads II, III, aVF developed ventricular tachycardia after an operation for thyroid carcinoma. Coronary arteriography revealed no organic stenosis, but acetylcholine induced total occlusion of the right coronary artery and severe narrowing of the left coronary artery. Left ventriculography showed inferoposterior and septal akinesis, and echocardiography revealed slight thinning of these affected walls. She had old myocardial infarction due to spasm. One year later, she developed bilateral uveitis and recurrence of tachycardia. Cardiac sarcoidosis was diagnosed by endomyocardial biopsy. In our patient with cardiac sarcoidosis, the presence of multivessel coronary spasm made the diagnosis difficult and may have contributed to cardiac dysfunction. Coronary arteries are rarely involved, but the development of coronary spasm may be linked to sarcoidosis.
一名63岁女性，II、III、aVF导联出现异常Q波，在甲状腺癌手术后发生室性心动过速。冠状动脉造影显示无器质性狭窄，但乙酰胆碱诱发右冠状动脉完全闭塞和左冠状动脉严重狭窄。左心室造影显示下后壁和室间隔运动减弱，超声心动图显示这些受累心肌壁轻度变薄。她患有因痉挛导致的陈旧性心肌梗死。一年后，她出现双侧葡萄膜炎和心动过速复发。经心内膜活检诊断为心脏结节病。在我们这位心脏结节病患者中，多支冠状动脉痉挛的存在使诊断困难，并且可能导致了心脏功能障碍。冠状动脉很少受累，但冠状动脉痉挛的发生可能与结节病有关。
