Ruisi Michael, Ruisi Phillip, Rosero Hugo, Schweitzer Paul
Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY, USA.
Rhode Island Hospital, Providence, RI, USA.
Case Rep Cardiol. 2013;2013:641348. doi: 10.1155/2013/641348. Epub 2013 Apr 23.
Prinzmetal angina or vasospastic angina is a clinical phenomenon that is often transient and self-resolving. Clinically it is associated with ST elevations on the electrocardiogram, and initially it may be difficult to differentiate from an acute myocardial infarction. The vasospasm induced in this setting occurs in normal or mildly to moderately diseased vessels and can be triggered by a number of etiologies including smoking, changes in autonomic activity, or drug ingestion. While the ischemia induced is usually transient, myocardial infarction and life-threatening arrhythmias can occur in 25% of cases. We present the case of a 65-year-old female where repetitive intermittent coronary vasospasm culminated in transmural infarction in the setting of gastrointestinal bleeding. This case highlights the mortality associated with prinzmetal angina and the importance of recognizing the underlying etiology.
变异型心绞痛或血管痉挛性心绞痛是一种临床现象，通常具有短暂性且可自行缓解。临床上，它与心电图上的ST段抬高有关，起初可能难以与急性心肌梗死相鉴别。在此情况下诱发的血管痉挛发生在正常或轻度至中度病变的血管中，可由多种病因触发，包括吸烟、自主神经活动变化或药物摄入。虽然诱发的缺血通常是短暂的，但25%的病例可能发生心肌梗死和危及生命的心律失常。我们报告一例65岁女性病例，其反复间歇性冠状动脉痉挛在胃肠道出血的情况下最终导致透壁性梗死。该病例突出了变异型心绞痛相关的死亡率以及识别潜在病因的重要性。
