Skála T, Hutyra M, Galuszka J, Fedorco M, Husár R, Richter M, Lukl J
I interní klinika Lékarské fakulty UP a FN Olomouc.
Vnitr Lek. 2007 Jun;53(6):724-8.
Malignant arrhythmia is a frequent complication of myocardial ischemia due to the occurrence of coronary artery spasm. The paper describes a patient with variant angina pectoris with an ICD implant who was repeatedly resuscitated for circulatory arrest in malignant arrhythmia. During myocardial ischemia the ECG showed elevations in the ST segments in the region of the ventral cardiac wall, with the formation of permanent polymorphous chamber tachycardia. External defibrillation was necessary due to recurrent tachyarrhythmias. A spasm developed when the RIA (radio immuno assay) was introduced during coronarography. The spasm started in the periphery of the artery and extended as far as the area of bifurcation with RD, with transitory closure of the artery and the development of chamber tachycardia. The patient fully recovered after the addition of Ca-blocker, nitrate depot and the withdrawal of the beta-blocker.
恶性心律失常是冠状动脉痉挛导致心肌缺血的常见并发症。本文描述了一名植入植入式心律转复除颤器（ICD）的变异型心绞痛患者，该患者因恶性心律失常导致循环骤停而多次复苏。心肌缺血期间，心电图显示心前壁区域ST段抬高，并形成持续性多形性室性心动过速。由于反复出现快速心律失常，需要进行体外除颤。冠状动脉造影期间引入放射免疫分析（RIA）时发生了痉挛。痉挛始于动脉外周，一直延伸至与右冠状动脉（RD）的分叉区域，导致动脉短暂闭塞并引发室性心动过速。添加钙通道阻滞剂、长效硝酸盐并停用β受体阻滞剂后，患者完全康复。
