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通过计算机断层扫描冠状动脉造影检测到的自发性冠状动脉痉挛:诱发痉挛部位类似于麦角新碱冠状动脉内注射而非乙酰胆碱。

Spontaneous coronary artery spasm detected by computed tomography coronary angiography: Provoked spasm site similar to intracoronary injection of ergonovine but not acetylcholine.

作者信息

Sueda Shozo, Kohno Hiroaki

机构信息

Department of Cardiology, Ehime Niihama Prefectural Hospital, Ehime, Japan.

Department of Cardiology, Tsukazaki Hospital, Himeji, Japan.

出版信息

J Cardiol Cases. 2019 Sep 7;20(6):209-212. doi: 10.1016/j.jccase.2019.08.013. eCollection 2019 Dec.

Abstract

A 61-year-old man was admitted to our hospital due to chest pain on both rest and effort. After the computed tomography coronary angiography, coronary stenosis was recognized at segment 3. Because inferior ischemia on stress myocardial perfusion scintigraphy with 201 thallium chloride induced by adenosine was found, we planned to perform the coronary intervention. After control coronary angiography, no significant stenosis was found in the right coronary artery. Intracoronary acetylcholine testing disclosed diffuse spasm at segment 4, whereas intracoronary ergonovine administration documented the total spasm at segment 3. After the intracoronary administration of nitrate, we diagnosed him with coronary spastic angina without organic stenosis. < We describe a case of coronary spastic angina whose spontaneous coronary spasm was detected by computed tomography coronary angiography incidentally.>.

摘要

一名61岁男性因静息及活动时胸痛入院。经计算机断层扫描冠状动脉造影后,发现冠状动脉3段狭窄。由于腺苷诱发的氯化铊应激心肌灌注显像显示下壁缺血,我们计划进行冠状动脉介入治疗。对照冠状动脉造影后,右冠状动脉未发现明显狭窄。冠状动脉内注射乙酰胆碱试验显示4段弥漫性痉挛,而冠状动脉内注射麦角新碱显示3段完全痉挛。冠状动脉内注射硝酸盐后,我们诊断他为无器质性狭窄的冠状动脉痉挛性心绞痛。<我们描述了一例冠状动脉痉挛性心绞痛病例,其自发性冠状动脉痉挛通过计算机断层扫描冠状动脉造影偶然发现。>

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