Halna du Fretay X, Blanchard-Lemoine B, Schnebert B, Viossat J
Centre d'exploration cardiovasculaire, Orléans, France.
Ann Cardiol Angeiol (Paris). 2011 Dec;60(6):317-23. doi: 10.1016/j.ancard.2011.09.002. Epub 2011 Oct 17.
Spastic angina is considered rare but its prevalence is probably underestimated especially in case of atherosclerotic coronary lesions. Its diagnosis remains important due to its poor prognosis and therapeutic characteristics. We report three clinical cases illustrating two different clinical presentations and the problem of diagnosis of spastic angina. We performed a review of the literature essentially concerning commonly used diagnosis means and especially provocative testing for coronary spasm. This test needs to be adapted to the evolution of techniques and uses of coronary angiography in 2011, particularly the wide spread use of radial approach. Therefore new recommendations are needed, specifying the terms of provocative testing and establishing clear diagnosis criteria including clinical, electrocardiographic and angiographic data. Such guidelines would probably help to better diagnose and treat these patients in our practice.
痉挛性心绞痛被认为较为罕见，但其患病率可能被低估，尤其是在动脉粥样硬化性冠状动脉病变的情况下。由于其预后较差和治疗特点，其诊断仍然很重要。我们报告了三例临床病例，展示了两种不同的临床表现以及痉挛性心绞痛的诊断问题。我们对文献进行了综述，主要涉及常用的诊断方法，尤其是冠状动脉痉挛激发试验。该试验需要适应2011年冠状动脉造影技术和应用的发展，特别是桡动脉途径的广泛使用。因此，需要新的建议，明确激发试验的条件，并建立包括临床、心电图和血管造影数据在内的明确诊断标准。这样的指南可能有助于我们在实践中更好地诊断和治疗这些患者。
