Engel H J, Page H L, Campbell W B
Am Heart J. 1976 Apr;91(4):501-6. doi: 10.1016/s0002-8703(76)80333-x.
Catheter-induced coronary artery spasm has been observed frequently. It is usually transient, reacts to the administration of nitroglycerin, and its distribution is generally confined to an area in proximity ot the intubated catheter. A 43-year-old woman with recurrent chest pain was found to have a rather long segment of tight proximal obstruction of the right coronary artery and experienced a myocardial infarction during coronary catheterization. Because of recurrent attacks of severe chest pain, coronary artery bypass surgery was performed which failed to result in significant improvement of her symptoms. Two repeat coronary cineangiograms seven weeks and three years after surgery revealed the proximal right coronary artery to be free of stenotic lesions or of luminal irregularities. After considering possible mechanisms of myocardial necrosis in the presence of normal coronary arteries it is concluded that myocardial necrosis can result from catheter-induced coronary artery spasm in spite of administration of nitroglycerin.
导管诱发的冠状动脉痉挛屡有观察到。它通常是短暂的，对硝酸甘油给药有反应，其分布一般局限于插管导管附近区域。一名43岁反复胸痛的女性在冠状动脉插管期间被发现右冠状动脉近端有一段相当长的严重狭窄梗阻，并经历了心肌梗死。由于严重胸痛反复发作，进行了冠状动脉搭桥手术，但未能显著改善她的症状。术后7周和3年的两次重复冠状动脉造影显示右冠状动脉近端无狭窄病变或管腔不规则。在考虑了冠状动脉正常情况下心肌坏死的可能机制后，得出结论：尽管使用了硝酸甘油，但导管诱发的冠状动脉痉挛仍可导致心肌坏死。
