Yang Ning-I, Hung Ming-Jui, Cherng Wen-Jin
Section of Cardiology, Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Keelung, Taiwan.
Angiology. 2007 Apr-May;58(2):156-60. doi: 10.1177/0003319707300350.
Fourteen patients with acute coronary syndrome are presented in this study. During angiography, hemodynamically significant coronary artery disease was demonstrated; however, it was not consistent with the electrocardiographic findings. The coronary artery spasm could be provoked in the rest of the angiographically normal coronary artery. Patient chest pain disappeared after administration of calcium channel blockers and/or isosorbide dinitrite. It is suggested that (1) both coronary artery spasm with no fixed stenosis and coronary atherosclerosis with fixed coronary stenosis can coexist in the same patient and cause symptoms, and (2) it is important to identify the predominant cause of symptoms, which then guides correct management.
本研究报告了14例急性冠状动脉综合征患者。在血管造影过程中，发现了具有血流动力学意义的冠状动脉疾病；然而，这与心电图结果不一致。在血管造影显示正常的冠状动脉其余部分可诱发冠状动脉痉挛。给予钙通道阻滞剂和/或亚硝酸异山梨酯后，患者胸痛消失。提示：（1）无固定狭窄的冠状动脉痉挛和有固定冠状动脉狭窄的冠状动脉粥样硬化可在同一患者中共存并引起症状；（2）识别症状的主要原因很重要，这将指导正确的治疗。
