Csapó K, Voith L, Medgyesi F, Hegedüs I, Mihóczy L
Orv Hetil. 1989 Dec 24;130(52):2779-80, 2783-4.
The authors survey the clinical features and therapeutic results of 88 patients suffering from late postinfarctional angina. The results of the bicycle ergometer ECG tests were negative only in the case of 8 patients. Exercise-induced silent myocardial ischaemia was registered in 45.4%. Coronary angiography revealed that 54 (61%) of the patients suffered from multivessel disease. Coronary bypass surgery was carried out in 56.8% and the rate of peripheral anastomoses was 3.1/patient. The authors consider it to be essential to detect the ischaemia in the infarct survivors with chest pain. Taking into consideration the clinical feature and the results of exercise tests, the authors propose cardiac catheterization. Myocardial revascularization is recommended if the medical therapy is not successful or the patients suffered from left main, triple-vessels disease and the myocardium is jeopardized to a large extend.
作者对88例陈旧性心肌梗死后心绞痛患者的临床特征及治疗结果进行了调查。仅8例患者的踏车心电图试验结果为阴性。运动诱发的无症状心肌缺血发生率为45.4%。冠状动脉造影显示,54例(61%)患者患有多支血管病变。56.8%的患者接受了冠状动脉搭桥手术,每位患者的外周吻合率为3.1。作者认为,对于有胸痛的心肌梗死存活者,检测缺血至关重要。考虑到临床特征和运动试验结果,作者建议进行心导管检查。如果药物治疗无效,或患者患有左主干、三支血管病变且心肌受到较大程度威胁,则建议进行心肌血运重建。