Özyüncü Nil, Göksülük Hüseyin, Vurgun Veysel Kutay, Yıldırım Onur, Tan Kürklü Türkan Seda
Department of Cardiology, Ankara University Faculty of Medicine, Ankara, Turkey.
Turk Kardiyol Dern Ars. 2017 Oct;45(7):641-645. doi: 10.5543/tkda.2017.44756.
Vasospastic angina, also known as Prinzmetal's angina, is thought to occur due to vascular hyper-reactivity to various stimuli. Response to medical therapy is usually good; however, 1 out of 5 patients has resistant symptoms. Rarely, potentially lethal arrhythmias can occur due to vasospasm, and those patients are reported to have a poorer prognosis. Presently described is a case of resistant vasospastic angina with persistent symptoms under calcium channel blocker and nitrate treatment. The patient presented with hemodynamically unstable rapid-rate ventricular tachycardia, which was quite resistant to recurrent cardioversion. She was treated with stent implantation for definite vasospastic segments of the coronaries, in combination with medical therapy. An implantable cardioverter defibrillator was also implanted for secondary prevention of ventricular arrhythmia, as vasospasm was considered to be a diffuse disease without a certain definitive treatment.
变异性心绞痛，也称为普林兹金属氏心绞痛，被认为是由于血管对各种刺激的高反应性而发生的。药物治疗的反应通常良好；然而，五分之一的患者有耐药症状。很少有患者会因血管痉挛而发生潜在致命性心律失常，据报道这些患者的预后较差。本文描述了一例在钙通道阻滞剂和硝酸盐治疗下仍有持续症状的耐药性变异性心绞痛病例。该患者出现血流动力学不稳定的快速室性心动过速，反复心脏复律效果不佳。她接受了冠状动脉明确痉挛节段的支架植入术，并结合药物治疗。还植入了植入式心脏复律除颤器用于室性心律失常的二级预防，因为血管痉挛被认为是一种无明确治疗方法的弥漫性疾病。
