Kinlay S, Selwyn A P, Ganz P, O'Gara P T
Cardiovascular Division, Brigham & Women's Hospital, Boston, Massachusetts 02115, USA.
Clin Cardiol. 2000 Nov;23(11):865-8. doi: 10.1002/clc.4960231117.
The case of a young man with spontaneous vasospasm at two sites in his left anterior descending coronary artery is described. Intravascular ultrasound demonstrated mild eccentric atherosclerosis with smaller total artery cross-sectional area (defined as the external elastic membrane) compared with reference segments. Impaired compensatory enlargement (remodeling) in response to mild atherosclerosis may derive from one or more biologic mechanisms that are also responsible for vasospasm. This characteristic is easily identified by intravascular ultrasound. In this case, coronary stenting of the vasospastic sites led to excellent long-term control of symptoms more than 1 year after intervention.
本文描述了一名年轻男性，其左前降支冠状动脉出现两处自发性血管痉挛。血管内超声显示存在轻度偏心性动脉粥样硬化，与参考节段相比，动脉总横截面积（定义为外弹力膜）较小。对轻度动脉粥样硬化的代偿性扩张（重塑）受损可能源于一种或多种也导致血管痉挛的生物学机制。这种特征通过血管内超声很容易识别。在该病例中，对血管痉挛部位进行冠状动脉支架置入术后，干预1年多来症状得到了很好的长期控制。
