Mohammed Ishaq, Zaatari Mohamad Sadek El, Tyrogalas Nikos, Khalid M I
Department of Cardiology/Medicine, West Midlands Deanery, Birmingham, UK.
Royal Shrewsbury Hospital, Shropshire, UK.
BMJ Case Rep. 2014 Aug 12;2014:bcr2013202586. doi: 10.1136/bcr-2013-202586.
Asymptomatic spontaneous coronary artery spasm is rare and there are no case reports in literature presenting with acute ST elevation on routine ECG. We present the case of a 68-year-old Caucasian man who presented to a primary care physician for a routine ECG as part of hypertension follow-up. ECG revealed ST elevation in inferior leads II, III and aVF with reciprocal ST depression in leads I, aVL and also ST depression in anterior leads V1, V2 and V3 suggesting ongoing inferoposterior ST elevation myocardial infarction. The patient was completely well, stable and asymptomatic and he was rushed immediately to the coronary care unit via emergency ambulance. The patient was subjected to a battery of urgent investigations which were all normal. Also an urgent coronary angiogram was undertaken which showed completely normal coronary anatomy.
无症状性自发性冠状动脉痉挛较为罕见，文献中尚无常规心电图出现急性ST段抬高的病例报道。我们报告一例68岁的白种男性病例，该患者因高血压随访前往基层医疗医生处进行常规心电图检查。心电图显示下壁导联II、III和aVF出现ST段抬高，I、aVL导联出现对应性ST段压低，前壁导联V1、V2和V3也出现ST段压低，提示正在发生下后壁ST段抬高型心肌梗死。患者状态良好、病情稳定且无症状，随后通过急救救护车被紧急送往冠心病监护病房。患者接受了一系列紧急检查，结果均正常。同时进行了紧急冠状动脉造影，显示冠状动脉解剖结构完全正常。
