Hayashi Takaharu, Ichikawa Minoru, Iwata Akio, Nakata Tsuyoshi, Lim Young-Jae, Mishima Masayoshi
Cardiovascular Division,Kawachi General Hospital, 1-31 Yokomakura, Higashi-osaka 578-0955, Japan.
Circ J. 2008 Feb;72(2):327-30. doi: 10.1253/circj.72.327.
A 49-year-old woman was referred to hospital because of chest discomfort. Coronary angiography revealed subtotal occlusion of the left coronary artery and the right coronary artery, but subsequent hemodynamic collapse occurred. Based on the results of intravascular ultrasound the occlusion was suspected to be caused by coronary vasospasm, which was not relieved by intracoronary injection of isosorbide dinitrate (1 mg), but was alleviated by nicorandil (2 mg), a potassium-channel opener. After discharge from hospital, the patient stopped taking her medication and returned complaining of chest discomfort again. Intravenous verapamil (5 mg) did not improve it, but direct intracoronary administration of nicorandil (2 mg) did bring relief. This case suggests that nicorandil is effective for coronary vasospasm.
一名49岁女性因胸部不适被转诊至医院。冠状动脉造影显示左冠状动脉和右冠状动脉次全闭塞，但随后发生了血流动力学崩溃。基于血管内超声结果，怀疑闭塞是由冠状动脉痉挛引起的，冠状动脉内注射硝酸异山梨酯（1毫克）未能缓解痉挛，但钾通道开放剂尼可地尔（2毫克）使其得到缓解。出院后，患者停止服药，再次因胸部不适前来就诊。静脉注射维拉帕米（5毫克）未能改善症状，但冠状动脉内直接注射尼可地尔（2毫克）确实缓解了症状。该病例表明尼可地尔对冠状动脉痉挛有效。
