Dagres N, Haude M, Baumgart D, Sack S, Erbel R
Department of Cardiology, Center of Internal Medicine, University of Essen, Germany.
Clin Cardiol. 2001 Mar;24(3):260-3. doi: 10.1002/clc.4960240318.
Patients with Guillain-Barré syndrome often have cardiac disturbances as a manifestation of autonomic dysfunction. Such abnormalities consist of arrhythmias and disturbances of heart rate and blood pressure. We report a case of a patient with Guillain-Barré syndrome who developed ST-segment elevation in the inferolateral leads, suggestive of an acute coronary syndrome. Cardiac catheterization revealed angiographically normal coronary arteries. Intracoronary ultrasound was also normal. Intracoronary Doppler flow measurements revealed an elevated baseline coronary flow velocity of up to 41 cm/s and decreased coronary flow reserve, particularly in the left circumflex artery. Myopericarditis as cause of the electrocardiographic changes could be ruled out by echocardiography and endomyocardial biopsy. We postulate that the intracoronary Doppler findings are caused by autonomic dysfunction with decrease of coronary resistance and redistribution of the transmural myocardial blood flow.
格林-巴利综合征患者常出现心脏紊乱，作为自主神经功能障碍的一种表现。此类异常包括心律失常以及心率和血压紊乱。我们报告一例格林-巴利综合征患者，其下侧壁导联出现ST段抬高，提示急性冠状动脉综合征。心脏导管检查显示冠状动脉造影正常。冠状动脉内超声检查也正常。冠状动脉内多普勒血流测量显示基线冠状动脉血流速度高达41厘米/秒且冠状动脉血流储备降低，尤其是在左旋支动脉。超声心动图和心内膜心肌活检可排除心肌炎作为心电图改变的原因。我们推测冠状动脉内多普勒检查结果是由自主神经功能障碍导致冠状动脉阻力降低和跨壁心肌血流重新分布所致。
