van Hougenhouck-Tulleken W G, Ueckermann V
Department of Internal Medicine, Faculty of Health Sciences, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa.
South Afr J Crit Care. 2019 Aug 15;35(1). doi: 10.7196/SAJCC.2019.v35i1.386. eCollection 2019.
Acute coronary syndromes due to coronary artery vasospasm occur rarely and are difficult to diagnose in the acute setting. We present a patient with hypocalcaemia-induced coronary artery vasospasm, which resulted in an acute ST-elevation myocardial infarction. This was reversible upon administering intravenous calcium, with no long-term cardiac consequences for our patient.
Hypocalcaemia is a common clinical problem that is usually clinically quiescent, but in the acute setting can present with dramatic signs and symptomsHypocalcaemia resulting in an acute coronary syndrome is usually rapidly reversed by administering intravenous calcium.A hypocalcaemia-induced acute coronary syndrome is most likely a function of the myocardium being perfused primarily during diastole, with partial vasospasm limiting the diastolic flow during times of increased cardiac output or energy requirements.
由冠状动脉血管痉挛引起的急性冠状动脉综合征很少见，在急性情况下难以诊断。我们报告一例因低钙血症诱发冠状动脉血管痉挛导致急性ST段抬高型心肌梗死的患者。静脉注射钙剂后病情可逆，患者无长期心脏后果。
低钙血症是常见的临床问题，通常临床症状不明显，但在急性情况下可出现显著的体征和症状。静脉注射钙剂通常可迅速逆转导致急性冠状动脉综合征的低钙血症。低钙血症诱发的急性冠状动脉综合征很可能是由于心肌主要在舒张期灌注，部分血管痉挛在心脏输出量增加或能量需求增加时限制了舒张期血流。
