The Queen Elizabeth Hospital, Discipline of Medicine, The University of Adelaide, Woodville South, South Australia, Australia.
Int J Evid Based Healthc. 2013 Mar;11(1):56-68. doi: 10.1111/1744-1609.12002.
Approximately 20% of patients undergoing diagnostic angiography for the evaluation of chest pain are found to have a normal coronary angiogram. Although this finding is generally associated with a low risk of cardiac events, approximately half will continue to experience chest pain over the next 12 months. Therefore, the finding of normal angiography warrants further evaluation of the potential causes for the presenting chest pain if we are to improve the disability suffered by these patients. In this review, the potential non-cardiac and cardiac causes for the chest pain in patients with normal angiography are briefly discussed with an in-depth focus on coronary vasomotor disorders including coronary artery spasm (variant angina) and microvascular disorders such as syndrome X, microvascular angina, the coronary slow flow phenomenon and microvascular spasm.
约 20% 接受诊断性冠状动脉造影以评估胸痛的患者被发现冠状动脉造影正常。尽管这一发现通常与心脏事件的低风险相关，但约一半患者在接下来的 12 个月内仍会持续胸痛。因此，如果要改善这些患者的残疾状况，那么在正常冠状动脉造影的情况下，就需要进一步评估潜在的胸痛原因。在本次综述中，简要讨论了冠状动脉造影正常患者胸痛的潜在非心脏和心脏原因，并深入探讨了包括冠状动脉痉挛（变异型心绞痛）和微血管障碍在内的冠状动脉血管舒缩障碍，如 X 综合征、微血管性心绞痛、冠状动脉慢血流现象和微血管痉挛。
