Hung M J, Wang C H, Kuo L T, Cherng W J
Department of Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan.
Tex Heart Inst J. 2000;27(2):212-4.
A 66-year-old man developed right coronary arterial spasm and hemodynamic decompensation during the early recovery phase of a treadmill exercise test. The unstable condition was corrected immediately after intravenous administration of atropine. A subsequent coronary angiographic study revealed insignificant right coronary artery stenosis. The pathophysiology of this response may be related to rapid alterations in autonomic balance during recovery after exercise. To our knowledge, this is the 1st reported case in which atropine effected immediate reversal of coronary arterial spasm and hemodynamic decompensation that were induced by exercise, rather than by pharmacologic agents. Atropine might be an effective treatment in patients who experience exercise-induced coronary arterial spasm and hemodynamic decompensation, but further investigation is warranted.
一名66岁男性在跑步机运动试验的早期恢复阶段出现右冠状动脉痉挛和血流动力学失代偿。静脉注射阿托品后，不稳定状况立即得到纠正。随后的冠状动脉造影研究显示右冠状动脉狭窄不明显。这种反应的病理生理学可能与运动后恢复过程中自主神经平衡的快速改变有关。据我们所知，这是首例报道的由运动而非药物诱导的冠状动脉痉挛和血流动力学失代偿经阿托品治疗后立即逆转的病例。阿托品可能是治疗运动诱发冠状动脉痉挛和血流动力学失代偿患者的有效药物，但仍需进一步研究。
