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治疗冠状动脉痉挛所致复发性多形性室性心动过速的挑战:一则有趣病例的经验教训

The challenges of treating recurrent polymorphic ventricular tachycardia due to coronary vasospasm: Lessons from an interesting case.

作者信息

Trehan Naveen, Rehman Mobeen Ur, Kottam Anupama

机构信息

Division of Cardiology, Department of Internal Medicine, Wayne State University, Detroit, MI 48201, USA.

Division of Cardiology, Department of Internal Medicine, Wayne State University, Detroit, MI 48201, USA.

出版信息

J Electrocardiol. 2017 Nov-Dec;50(6):972-974. doi: 10.1016/j.jelectrocard.2017.07.003. Epub 2017 Jul 12.

Abstract

Coronary artery vasospasm can cause recurrent anginal episodes with ST-segment elevation. Vasospasm induced myocardial ischemia can lead to arrhythmias including life threatening ventricular tachycardia (VT). Percutaneous coronary intervention (PCI), although not routinely recommended for treating vasospastic angina, can be considered for discrete coronary spasm that is not amenable to vasodilator therapy. We present a challenging case of a 41-year-old lady with recurrent episodes of vasospastic angina and VT refractory to medical therapy, which was successfully treated with PCI and an implantable cardioverter defibrillator.

摘要

冠状动脉血管痉挛可导致伴有ST段抬高的复发性心绞痛发作。血管痉挛诱发的心肌缺血可导致心律失常,包括危及生命的室性心动过速(VT)。经皮冠状动脉介入治疗(PCI)虽然通常不推荐用于治疗血管痉挛性心绞痛,但对于不适合血管扩张剂治疗的局限性冠状动脉痉挛可考虑使用。我们报告一例具有挑战性的病例,一名41岁女性患有复发性血管痉挛性心绞痛和室性心动过速,药物治疗无效,经PCI和植入式心脏复律除颤器成功治疗。

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