Division of Cardiology, The Southern Arizona VA Health Care System, and University of Arizona Sarver Heart Center, Tucson, AZ, USA.
Rev Cardiovasc Med. 2010 Fall;11(4):264-70. doi: 10.3909/ricm0545.
Formally described by Prinzmetal and colleagues in 1959, variant angina represents a syndrome of resting angina that results from severe coronary artery vasospasm associated with ST elevation. The majority of patients respond to nitrates or calcium channel blockers. However, medical treatment-resistant vasospasm can occur in up to 20% of cases, thus requiring further interventions. We present a rare instance of coronary vasospasm associated with complete heart block resistant to medical therapy that was successfully treated with stenting. This case example is followed by a detailed review of the literature with regard to percutaneous or surgical coronary revascularization of patients with medically resistant vasospasm.
1959 年，由 Prinzmetal 及其同事正式描述，变异性心绞痛是一种静息性心绞痛综合征，由严重的冠状动脉痉挛引起，伴有 ST 段抬高。大多数患者对硝酸酯类或钙通道阻滞剂有反应。然而，高达 20%的病例可能出现药物治疗抵抗性的血管痉挛，因此需要进一步的干预措施。我们报告了一例罕见的与完全性心脏阻滞相关的冠状动脉痉挛，该病例对药物治疗有抵抗，经支架置入治疗后成功缓解。随后对文献进行了详细回顾，包括药物治疗抵抗性血管痉挛患者的经皮或手术冠状动脉血运重建。
