Gaspardone A, Tomai F, Penta de Peppo A, Chiariello L, Gioffrè P A
Servizio Speciale di Diagnosi e Cura di Emodinamica, Università degli Studi Tor Vergata, European Hospital, Roma.
Cardiologia. 1992 Oct;37(10):701-4.
A 58-year-old woman, referred to our hospital to undergo invasive assessment of mitral valve stenosis, demonstrated prolonged asymptomatic catheter-induced left anterior descending and right coronary artery spasm during coronary arteriography. Coronary spasms were not associated with ECG and arterial blood pressure changes. Intracoronary injection of nitroglycerin (300 and 600 micrograms bolus) did not resolve coronary spasm. Coronary angiography, repeated 24 hours later using the same procedure and materials, did not show any evidence of coronary artery spasm. The present clinical case is interesting for 3 reasons. First, the presence of prolonged proximal double-vessel coronary spasm not associated with symptoms or signs of acute myocardial ischemia; second, the incapacity of high dose of intracoronary nitroglycerin to resolve the coronary spasm; third, the dramatic changes in the sensitivity of coronary artery to mechanical stimulation in different days.
一名58岁女性因需对二尖瓣狭窄进行侵入性评估而转诊至我院，在冠状动脉造影期间，其左前降支和右冠状动脉出现了长时间无症状的导管诱导痉挛。冠状动脉痉挛与心电图及动脉血压变化无关。冠状动脉内注射硝酸甘油（300和600微克推注）未能缓解冠状动脉痉挛。24小时后使用相同的程序和材料重复进行冠状动脉造影，未显示任何冠状动脉痉挛的迹象。本临床病例因三个原因而有趣。第一，存在长时间的近端双支冠状动脉痉挛，且与急性心肌缺血的症状或体征无关；第二，高剂量冠状动脉内硝酸甘油无法缓解冠状动脉痉挛；第三，不同日期冠状动脉对机械刺激的敏感性发生了显著变化。
