Ujhelyi E, Böhm A, Tóth C, Préda I
Markhot Ferenc Megyei Kórház, Eger, Kardiológiai Osztály.
Orv Hetil. 2001 Aug 19;142(33):1809-11.
The authors report on the case of a 61 year-old female patient who was repeatedly taken to hospital because of chest pain and temporary loss of consciousness. During her hospitalization there was no ST elevation on the ECG, sinus bradycardia, other times atrial fibrillation was detected. The diagnosis was made by Holter monitoring three years after the onset of complaints. At this time chest pain set in after midnight, which was followed by loss of consciousness. Significant ST elevation and IIIrd degree AV block were detected. The coronarography showed non-significant coronary stenosis. According to the vasospastic patomechanism nitrate, calcium antagonist and acetylsalicylic acid therapy was administered and because of the complete AV block leading to syncope a VVI, M pacemaker was implanted. During the two years passed since the implantation of the pacemaker the patient had chest pain only once and it was not accompanied by syncope.
作者报告了一例61岁女性患者的病例，该患者因胸痛和短暂意识丧失多次入院。住院期间，心电图无ST段抬高，有窦性心动过缓，其他时候检测到房颤。在出现症状三年后通过动态心电图监测做出诊断。此时，午夜后出现胸痛，随后意识丧失。检测到明显的ST段抬高和三度房室传导阻滞。冠状动脉造影显示冠状动脉狭窄不明显。根据血管痉挛发病机制，给予硝酸盐、钙拮抗剂和乙酰水杨酸治疗，由于完全性房室传导阻滞导致晕厥，植入了VVI、M型起搏器。自起搏器植入后的两年里，患者仅出现过一次胸痛，且未伴有晕厥。
