Meluzín J, Januska B
I. interní klinika fakultní nemocnice s poliklinikou KUNZ, Brno.
Cas Lek Cesk. 1990 Dec 14;129(50):1590-2.
The authors describe the case of a 57-year-old male patient with severe left ventricular dysfunction (ejection fraction of left ventricle--37%, left ventricular end diastolic pressure 32 mm Hg) as a result of an extensive anterior Q infarction of the heart muscle. The patient did not have signs of congestive heart failure. He was treated on account of angina pectoris on exertion, grade III according to NYHA, hypertension and diabetes. Nifedipine and diltiazem administration led to repeated attacks of cardiac asthma. Calcium channel blockers should be administered to patients with angina pectoris and severe left ventricular dysfunction only when nitrates alone do not eliminate ischaemia and pain. They should be administered carefully and with the knowledge that they may in rare instances cause clinical deterioration of left ventricular function.
作者描述了一名57岁男性患者的病例，该患者因广泛前壁心肌梗死导致严重左心室功能不全（左心室射血分数为37%，左心室舒张末期压力为32 mmHg）。患者无充血性心力衰竭体征。因其劳力性心绞痛（纽约心脏协会分级为III级）、高血压和糖尿病接受治疗。服用硝苯地平和地尔硫䓬导致反复发生心源性哮喘。仅当单独使用硝酸盐不能消除缺血和疼痛时，才应将钙通道阻滞剂用于患有心绞痛和严重左心室功能不全的患者。使用时应谨慎，并了解它们在极少数情况下可能导致左心室功能临床恶化。
