Department of Cardiology, Ehime Niihama Prefectural Hospital.
Circ J. 2019 Aug 23;83(9):1925-1928. doi: 10.1253/circj.CJ-19-0433. Epub 2019 Aug 2.
Japanese Circulation Society (JCS) guidelines do not include adolescents with coronary artery spasm.
We recruited 18 adolescents less than 20 years old with vasospastic angina (VSA): 11 were Japanese and 3 had chest symptoms for >12 months before admission. ST-segment elevation was observed in 11 patients and none of the 18 patients had a fixed stenosis. Spasm provocation tests were performed in 9 patients and two-thirds had multiple spasms; 6 suffered from acute myocardial infarction and ventricular fibrillation occurred in 2 patients; 1 patient died and the remaining 17 patents survived.
Clinical status of adolescents with VSA was as severe as in adults with refractory VSA. Cardiologists should cooperate with pediatricians to diagnose and treat adolescents with VSA. There is a need to establish the additional issues for adolescents with coronary spasm in the JCS guidelines.
日本循环学会(JCS)指南不包括冠状动脉痉挛的青少年患者。
我们招募了 18 名年龄小于 20 岁的伴有血管痉挛性心绞痛(VSA)的青少年:11 名是日本人,3 名在入院前有>12 个月的胸痛症状。11 名患者出现 ST 段抬高,18 名患者中没有固定狭窄。9 名患者进行了痉挛激发试验,三分之二的患者有多发性痉挛;6 名患者发生急性心肌梗死,2 名患者发生心室颤动;1 名患者死亡,其余 17 名患者存活。
伴有 VSA 的青少年的临床状况与难治性 VSA 的成人一样严重。心脏病专家应与儿科医生合作,诊断和治疗伴有 VSA 的青少年。JCS 指南中需要为伴有冠状动脉痉挛的青少年制定额外的问题。