Department of Cardiology, Matsushita Memorial Hospital, Osaka, Japan.
Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Ann Noninvasive Electrocardiol. 2020 Nov;25(6):e12759. doi: 10.1111/anec.12759. Epub 2020 Apr 26.
Acute inferior myocardial damage can induce transient bradycardia and hypotension-the Bezold-Jarisch reflex, which is explained by the preferential distribution of vagal nerves in the inferior wall of the left ventricle. We report a 76-year-old man who showed a perfusion defect in the inferior wall with redistribution on exercise scintigraphy with thallium-201. Of note, during exercise at an intensity of 100 watts, the patient's heart rate transiently decreased from 122 to 95 bpm in sinus rhythm, accompanied by ST-segment depression. A diagnosis of coronary spastic angina was made since no stenotic lesions were observed on conventional coronary angiography.
急性下壁心肌损伤可引起短暂性心动过缓和低血压——贝佐尔德-贾里希反射，这是由于迷走神经在下壁左心室中的优先分布所致。我们报告了一例 76 岁男性，其运动闪烁扫描显示 201 铊灌注缺陷，下壁有再分布。值得注意的是，在 100 瓦强度的运动过程中，患者的窦性心律的心率从 122 次/分短暂下降至 95 次/分，同时伴有 ST 段压低。由于常规冠状动脉造影未发现狭窄性病变，诊断为冠状动脉痉挛性心绞痛。
