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[运动中断引发的变异型心绞痛。5例冠状动脉造影正常的病例]

[Prinzmetal's angina initiated by interruption of exercise. 5 cases with normal coronary radiograms].

作者信息

Broustet J P, Griffo R, Seriès E, Guern P, Laylavoix F

出版信息

Arch Mal Coeur Vaiss. 1979 Apr;72(4):391-400.

PMID:112938
Abstract

Five male patients, aged between 31 and 58 years, presented with anginal chest pain with nausea and sweating after the interruption of exercise. Prinzmetal variant angina was observed during the recovery phase of exercise tolerance testing. Coronary arteriography and selective left ventricular angiography were normal in all cases. Ergonovine, used in one case, induced coronary artery spasm. The angina was eased by Nifedipine in three patients and passed off with time in the other two patients. In one case attack occurred with amiodarone therapy and in another with glyceril trinitrate, after normal exercise tolerance tests. Vagotonia, all the more pronounced when sympathetic tonus is increased, and hyperventilation seem to be the causative factors of what probably results from coronary artery spasm. Nifedipine, a calcium-blocking agent would appear to be the treatment of choice.

摘要

5名年龄在31至58岁之间的男性患者,在运动中断后出现伴有恶心和出汗的心绞痛。在运动耐量测试的恢复阶段观察到变异型心绞痛(普林兹金属心绞痛)。所有病例的冠状动脉造影和选择性左心室造影均正常。1例使用麦角新碱诱发冠状动脉痉挛。3例患者服用硝苯地平后心绞痛缓解,另外2例患者的症状随时间自行消失。在1例患者中,运动耐量测试正常后,胺碘酮治疗引发了发作;在另一例患者中,硝酸甘油引发了发作。迷走神经张力亢进,在交感神经张力增加时更为明显,以及过度通气似乎是冠状动脉痉挛可能导致的原因。钙阻滞剂硝苯地平似乎是首选治疗药物。

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