Adachi Yusuke, Ikeda Nahoko, Sakakura Kenichi, Netsu Sachiho, Ibe Tatsuro, Wada Hiroshi, Momomura Shin-Ichi, Fujita Hideo
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Japan.
Intern Med. 2016;55(18):2639-42. doi: 10.2169/internalmedicine.55.6947. Epub 2016 Sep 15.
A 44-year-old woman, who had been previously diagnosed with coronary spastic angina and treated with standard medical therapy including calcium channel blockers, was admitted to our hospital due to chest pain at rest. Her chest pain attacks were concentrated just before and during menstruation. Despite the administration of an intravenous infusion of nitroglycerin and nicorandil, strong heart attacks with ST elevation occurred frequently after this admission. However, following continuous combined estrogen-progestin hormonal contraception use (estradiol plus dienogest), her attacks disappeared completely. Reduced estrogen levels before and during menstruation were speculated to be associated with her angina attacks.
一名44岁女性，此前被诊断为冠状动脉痉挛性心绞痛，并接受了包括钙通道阻滞剂在内的标准药物治疗，因静息时胸痛入院。她的胸痛发作集中在月经前和月经期间。入院后，尽管静脉输注了硝酸甘油和尼可地尔，但仍频繁发生伴有ST段抬高的严重心脏病发作。然而，在持续使用复方雌激素 - 孕激素激素避孕法（雌二醇加地诺孕素）后，她的发作完全消失了。推测月经前和月经期间雌激素水平降低与她的心绞痛发作有关。
