Cannon R O
Cardiovascular Diagnosis Section, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
Cardiol Clin. 1991 Feb;9(1):157-66.
Of patients with angina pectoris who undergo cardiac catheterization, angiographically normal-appearing coronary arteries are found in a significant minority. Multiple etiologies have been proposed to explain chest pain in this setting, including psychiatric illness, esophageal motility disorders or acid reflux, and limited coronary flow response to stress. A fundamental abnormality in this patient population may be abnormal visceral pain perception. Evidence for and against various etiologies as well as a management strategy for the patient with chest pain are presented in this article, both with respect to the decision for performing cardiac catheterization and the management after demonstration of angiographically normal coronary arteries.
在接受心导管插入术的心绞痛患者中，相当一部分患者的冠状动脉造影显示正常。针对这种情况下的胸痛，已经提出了多种病因，包括精神疾病、食管动力障碍或胃酸反流，以及应激状态下冠状动脉血流反应受限。这类患者的一个根本异常可能是内脏痛觉异常。本文针对胸痛患者，阐述了支持和反对各种病因的证据以及管理策略，内容涉及进行心导管插入术的决策以及冠状动脉造影显示正常后的管理。
