Buslenko N S, Fitileva L M, Komarova V A, Grigor'eva L M, Pastukh A N
Kardiologiia. 1987 Oct;27(10):23-6.
Clinical manifestations were compared in coronary patients with different sites and spread of coronary atherosclerosis, in order to assess the feasibility of differential diagnosis of left coronary arterial (LCA) trunk lesions versus multiple coronary arterial stenoses. Four groups of patients were examined: isolated third- or fourth-degree LCA trunk stenosis (15 patients, group 1); third- or fourth-degree stenosis of the anterior interventricular branch (AIVB) and the circumflex branch (CB) (44 patients, group 2); third- or fourth-degree stenosis of AIVB, CB or the right coronary artery (RCA) (77 patients, group 3); and third- or fourth-degree stenosis of AIVB, CB, the diagonal branch or RCA (33 patients, group 4). The clinical condition of patients with isolated LCA branch lesions was much worse than that of patients with multiple coronary arterial stenosis. Differential diagnosis is based on the severity of the pain syndrome, the spread of ischemic zone on resting ECG, the scope of past myocardial infarction, stress tolerance and the magnitude of ST depression in response to exercise.
比较了患有不同部位和范围冠状动脉粥样硬化的冠心病患者的临床表现，以评估鉴别诊断左冠状动脉主干病变与多支冠状动脉狭窄的可行性。对四组患者进行了检查：孤立的三度或四度左冠状动脉主干狭窄（15例患者，第1组）；前室间支和旋支的三度或四度狭窄（44例患者，第2组）；前室间支、旋支或右冠状动脉的三度或四度狭窄（77例患者，第3组）；以及前室间支、旋支、对角支或右冠状动脉的三度或四度狭窄（33例患者，第4组）。孤立性左冠状动脉分支病变患者的临床状况比多支冠状动脉狭窄患者的临床状况差得多。鉴别诊断基于疼痛综合征的严重程度、静息心电图上缺血区的范围、既往心肌梗死的范围、运动耐力以及运动时ST段压低的幅度。
