Cipriano P R, Silverman J F, Perlroth M G, Griepp R B, Wexler L
Am J Cardiol. 1977 May 4;39(5):744-50. doi: 10.1016/s0002-9149(77)80139-2.
A patient with Takayasu's aortitis and angina pectoris due to severe narrowing of the right and left coronary arterial ostia is described. Takayasu's arteritis produces a panaortitis, with thickening of the adventitia predominating, and an inflammatory cell infiltrate involving the adventitia, outer media and vasa vasorum. Narrowing of the coronary arteries in this disease is due to extension into these arteries of the processes of proliferation of the intima and contraction of the fibrotic media and adventitia that occur in the aorta. The distal coronary arteries usually do not manifest arteritis and are normal in caliber. Angina pectoris may be the first symptom of the disease if the coronary arteries are the initial site of severe arterial narrowing. The coronary arterial bypass graft operation is effective therapy for treating coronary arterial narrowing due to Takayasu's arteritis.
本文描述了一名患有高安动脉炎且因左右冠状动脉开口严重狭窄而出现心绞痛的患者。高安动脉炎会引发全主动脉炎，以外膜增厚为主，并伴有炎症细胞浸润，累及外膜、中膜外层和滋养血管。该疾病中冠状动脉狭窄是由于主动脉出现的内膜增生、纤维化中膜和外膜收缩过程扩展至这些动脉所致。冠状动脉远端通常不表现出动脉炎，管径正常。如果冠状动脉是严重动脉狭窄的起始部位，心绞痛可能是该疾病的首发症状。冠状动脉搭桥手术是治疗高安动脉炎所致冠状动脉狭窄的有效疗法。
