Wu D J, Mifune J, Taga K, Hifumi S, Takahashi Y, Yamashida S, Nishioka S, Murakami T, Tanaka T
Department of Internal Medicine, Fukui Cardiovascular Center, Japan.
Jpn Heart J. 1990 Jan;31(1):109-13. doi: 10.1536/ihj.31.109.
A case of a 73-year-old man with variant angina who developed chest pain and shock following an injection of sodium bicarbonate and hydrocortisone is reported. The electrocardiogram (ECG) during the chest pain attack revealed ST elevation in leads II, III and aVF. It returned to a normal pattern 10 min later. Coronary angiography, performed 2 hours after the anginal attack, showed no significant coronary arterial stenosis. One month later, an injection of ergonovine (16 micrograms) into the right and left coronary arteries induced spasms in segments 4 and 13, with ischemic ECG changes. Possible causes of the anginal attack are a coronary arterial spasm induced by the allergic reaction to hydrocortisone and/or serum alkalosis due to the sodium bicarbonate injection triggered by hyperventilation.
报告了一例73岁变异型心绞痛男性患者，在注射碳酸氢钠和氢化可的松后出现胸痛和休克。胸痛发作时的心电图（ECG）显示II、III和aVF导联ST段抬高。10分钟后恢复正常形态。心绞痛发作2小时后进行的冠状动脉造影显示无明显冠状动脉狭窄。1个月后，向左右冠状动脉注射麦角新碱（16微克）诱发4段和13段痉挛，并伴有缺血性心电图改变。心绞痛发作的可能原因是对氢化可的松的过敏反应引起冠状动脉痉挛和/或过度通气触发的碳酸氢钠注射导致的血清碱中毒。
