Bech J, Madsen J K, Grande P, Efsen F
Kardiologisk laboratorium, medicinsk afdeling B, og kardiovaskulaert afsnit, radiologisk afdeling X, Rigshospitalet, København.
Ugeskr Laeger. 1992 Jul 20;154(30):2077-80.
Coronary arteriography was performed in 50 patients aged 40 years of less all of whom had had acute myocardial infarction (AMI). Forty-seven patients had at least one risk factor for development of ischaemic cardiac disease. Smoking and familial predisposition were the commonest predisposing factors. Seventeen patients had stenosis in a single coronary artery only. Six patients had three-vessel disease and none had stenosis of the main stem of the left coronary artery. Eight patients had no stenoses. All patients with three-vessel disease had sign of ischaemia after infarction. The type of infarction was related to the number of stenosed vessels, so that patients with Q-wave infarction had a greater number of stenoses than patients with non-Q-wave infarcts. A congenital coronary in the form of abnormal origin of the left coronary artery from the pulmonary artery was the cause of AMI in an isolated case. On the basis of this retrospective investigation, the authors have assessed the value of routine coronary arteriography (CAG) in 50 relatively young patients who had recently sustained AMI. CAG does not appear to be indicated as a routine procedure in all of these patients but could have been performed primarily on the basis of symptoms or the findings from non-invasive investigations.
对50名年龄在40岁及以下且均患有急性心肌梗死（AMI）的患者进行了冠状动脉造影。47名患者至少有一项缺血性心脏病发病的危险因素。吸烟和家族易感性是最常见的诱发因素。17名患者仅在单支冠状动脉有狭窄。6名患者有三支血管病变，且无人有左冠状动脉主干狭窄。8名患者无狭窄。所有有三支血管病变的患者在梗死后均有缺血迹象。梗死类型与狭窄血管数量有关，因此Q波梗死患者的狭窄数量多于非Q波梗死患者。在一例孤立病例中，左冠状动脉起源于肺动脉的先天性冠状动脉异常是AMI的病因。基于这项回顾性研究，作者评估了常规冠状动脉造影（CAG）在50名近期发生AMI的相对年轻患者中的价值。CAG似乎并非所有这些患者的常规检查，但本可主要根据症状或无创检查结果进行。
