Teragawa Hiroki, Oshita Chikage, Ueda Tomohiro
Department of Cardiovascular Medicine, JR Hiroshima Hospital, Japan.
Intern Med. 2020 Jan 1;59(1):89-92. doi: 10.2169/internalmedicine.3266-19. Epub 2019 Sep 3.
A 61-year-old man experienced chest oppression for 1 hour. He was positive for troponin T and underwent emergent coronary angiography (CAG), which did not reveal significant coronary stenosis. He was diagnosed with myocardial infarction with nonobstructive coronary arteries (MINOCA). We performed a spasm-provocation test, which revealed a focal spasm at the segment of the myocardial bridge. After receiving a calcium-channel blocker, he exhibited a good clinical course. Coronary spasm is considered an underlying cause of MINOCA; therefore, the presence of a myocardial bridge may help with the diagnosis.
一名61岁男性经历了1小时的胸部压迫感。他肌钙蛋白T呈阳性,接受了急诊冠状动脉造影(CAG),结果未显示明显的冠状动脉狭窄。他被诊断为非阻塞性冠状动脉心肌梗死(MINOCA)。我们进行了痉挛激发试验,结果显示心肌桥节段存在局灶性痉挛。在接受钙通道阻滞剂治疗后,他的临床病程良好。冠状动脉痉挛被认为是MINOCA的潜在病因;因此,心肌桥的存在可能有助于诊断。