Suzuki Kengo, Akashi Yoshihiro J, Mizukoshi Kei, Kou Seisyou, Takai Manabu, Izumo Masaki, Shimozato Takashi, Hayashi Akio, Ohtaki Eiji, Nobuoka Sachihiko, Miyake Fumihiko
Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
BMJ Case Rep. 2010 Nov 29;2010:bcr0620103060. doi: 10.1136/bcr.06.2010.3060.
A 47-year-old male presented with chest discomfort while sleeping. The patient was suspected of having vasospastic angina (VSA) and underwent hyperventilation and cold-pressor stress echocardiography. No chest pain, ECG changes or decreased wall motion was found. However, automated function imaging (AFI) showed decreased peak systolic strain at the apex and postsystolic shortening at both the apex and inferior wall, which was not found before the test. The provocation test revealed 99% stenosis in the right coronary artery #2 at a dose of 50 μg acetylcholine and 90% stenosis in the left coronary artery #8 at a dose of 100 μg. The patient was thus diagnosed as having VSA. The present case demonstrates the usefulness of AFI combined with hyperventilation and cold-pressor stress echocardiography as a screening examination for VSA.
一名47岁男性在睡眠时出现胸部不适。该患者被怀疑患有血管痉挛性心绞痛（VSA），并接受了过度换气和冷加压应激超声心动图检查。未发现胸痛、心电图改变或室壁运动减弱。然而，自动功能成像（AFI）显示心尖处收缩期峰值应变降低，心尖和下壁均出现收缩期后缩短，这在检查前未被发现。激发试验显示，在给予50μg乙酰胆碱时，右冠状动脉#2处狭窄99%，在给予100μg时，左冠状动脉#8处狭窄90%。因此，该患者被诊断为患有VSA。本病例证明了AFI联合过度换气和冷加压应激超声心动图作为VSA筛查检查的有用性。
