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烟雾病中的变异型心绞痛——相关病因及不同表现：一例病例报告

Variant angina in moyamoya disease--a correlative etiology and different presentation: a case report.

作者信息

Choi Woong, Kim Yu Na, Kim Kyung-Hee

机构信息

Division of Cardiology, Department of Internal Medicine, Sejong General Hospital & Sejong Heart Institute, Hyohyunro 489 street, Bucheon, Kyunggi-do, Republic of Korea.

出版信息

J Med Case Rep. 2015 Apr 22;9:86. doi: 10.1186/s13256-015-0537-4.

DOI:10.1186/s13256-015-0537-4
PMID:25895677
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4423640/
Abstract

INTRODUCTION

Moyamoya disease is characterized by progressive steno-occlusive changes of the distal internal carotid and developed collateral vasculature, so called 'moyamoya' vessels at the base of the brain. Variant angina is a rare occurrence in patients with moyamoya disease.

CASE PRESENTATION

Here we report the case of a 41-year-old Korean woman who developed chest pain after indirect revascularization surgery of moyamoya disease. A treadmill test and an exercise stress echocardiograph showed positive results, but there was no significant major coronary arteries stenosis. Suspicious of vasospasm, we conducted an ergonovine spasm stimulation test, which demonstrated tight stenosis of her proximal left anterior descending artery. At the site of spasm, intravascular ultrasound virtual histology showed intraluminal fibrous plaque.

CONCLUSION

Physicians who follow up patients with moyamoya disease would need to be aware of the possibility of cardiac ischemia as well as neurological manifestations.

摘要

引言

烟雾病的特征是颈内动脉远端进行性狭窄闭塞性改变以及大脑底部形成侧支血管，即所谓的“烟雾状”血管。变异型心绞痛在烟雾病患者中较为罕见。

病例报告

在此，我们报告一例41岁韩国女性患者，其在烟雾病间接血运重建手术后出现胸痛。平板运动试验和运动负荷超声心动图结果呈阳性，但主要冠状动脉无明显狭窄。怀疑有血管痉挛，我们进行了麦角新碱痉挛刺激试验，结果显示其左前降支近端严重狭窄。在痉挛部位，血管内超声虚拟组织学显示管腔内纤维斑块。

结论

随访烟雾病患者的医生需要意识到心脏缺血以及神经学表现的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d6/4423640/69b3c49b884e/13256_2015_537_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d6/4423640/424fd325a0cd/13256_2015_537_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d6/4423640/2550b2316359/13256_2015_537_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d6/4423640/2ec835bd530b/13256_2015_537_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d6/4423640/69b3c49b884e/13256_2015_537_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d6/4423640/424fd325a0cd/13256_2015_537_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d6/4423640/2550b2316359/13256_2015_537_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d6/4423640/2ec835bd530b/13256_2015_537_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4d6/4423640/69b3c49b884e/13256_2015_537_Fig4_HTML.jpg

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