Cannon R O
Cardiovascular Diagnosis Section, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
Med Clin North Am. 1991 Sep;75(5):1097-118. doi: 10.1016/s0025-7125(16)30401-1.
A significant minority of patients with chest pain who undergo cardiac catheterization are found to have angiographically normal coronary arteries. Over the past 25 years, several studies have shown that a subset have demonstrable abnormalities in coronary flow and cardiac function; however, only a minority of these patients have convincing evidence for myocardial ischemia during stress, and alternative mechanisms have been explored to explain the frequent and debilitating symptoms of pain experienced by the majority of these patients undergoing study. Abnormal visceral nociception appears to be a fundamental abnormality in this population, whether or not demonstrable abnormalities in coronary flow or cardiac function can be demonstrated.
接受心导管检查的胸痛患者中，有相当一部分人的冠状动脉造影显示正常。在过去25年里，多项研究表明，其中一部分患者存在冠状动脉血流和心脏功能的明显异常；然而，这些患者中只有少数在应激时具有令人信服的心肌缺血证据，并且已经探索了其他机制来解释这些接受研究的大多数患者频繁出现的使人虚弱的疼痛症状。无论是否能证明冠状动脉血流或心脏功能存在明显异常，内脏伤害感受异常似乎是这一人群的根本异常。
