Lee Chi-Hang, Seow Swee-Chong, Lim Yean-Teng
Interventional Cardiologist, Cardiology Department, National University Hospital, Level 3, Main Building, 5, Lower Kent Ridge Road, 119074, Singapore.
J Invasive Cardiol. 2008 Jan;20(1):E30-2.
Isolated coronary artery spasm without atherosclerotic obstruction is an unusual cause of myocardial infarction (MI). A middle-aged woman presented to our institution in 2001 with acute inferior MI due to coronary artery spasm at the mid segment of the dominant left circumflex coronary artery. After being well for 6 years, she was readmitted again in 2007 with the same type of severe retrosternal chest pain. Electrocardiography (ECG) showed ST-segment elevation over the inferior leads. The chest pain resolved with sublingual nitroglycerin and emergency diagnostic coronary angiography showed normal coronary arteries. Two months later, the patient developed another episode of severe retrosternal chest pain at home, followed by cardiac arrest. An onsite ECG showed ventricular fibrillation and immediate defibrillation was carried out. She was readmitted to the hospital and recovered over the next few days. In view of the recurrent coronary artery spasm causing myocardial infarction and ventricular fibrillation, an implantable cardioverter defibrillator was implanted. The patient was well at 2-month follow up.
无动脉粥样硬化阻塞的孤立性冠状动脉痉挛是心肌梗死（MI）的一种罕见病因。一名中年女性于2001年因左回旋支冠状动脉中段的冠状动脉痉挛导致急性下壁心肌梗死前来我院就诊。病情稳定6年后，她于2007年再次入院，出现同样类型的严重胸骨后胸痛。心电图（ECG）显示下壁导联ST段抬高。舌下含服硝酸甘油后胸痛缓解，急诊诊断性冠状动脉造影显示冠状动脉正常。两个月后，患者在家中再次出现严重的胸骨后胸痛，随后发生心脏骤停。现场心电图显示心室颤动，立即进行了除颤。她被收入院，在接下来的几天里康复。鉴于反复发生的冠状动脉痉挛导致心肌梗死和心室颤动，植入了植入式心脏复律除颤器。患者在2个月的随访时情况良好。
