Sclarovsky S, Davidson E, Strasberg B, Lewin R F, Arditti A, Wurtzel M, Agmon J
Am Heart J. 1986 Sep;112(3):463-7. doi: 10.1016/0002-8703(86)90507-7.
We evaluated 46 patients with unstable angina (UA), who showed no significant changes in heart rate, blood pressure, and double product (as evidence of increased oxygen demand) during episodes of chest pain. Coronary angiography was performed in all patients during the same hospitalization. Of 26 patients with UA and ST depression (group A), 10 had left main coronary artery disease (CAD) and eight had left main equivalent CAD. Of 20 patients with UA and ST elevation (group B), only one had left main CAD and one had left main equivalent CAD. All patients in group A had ST depression in leads V4 and V5, and all patients in group B had ST elevation in leads V2 and V3. The presence of ST depression in leads V4 and V5 in UA patients without evidence of increased oxygen demand may be suggestive of significant left main or left main equivalent CAD. Therefore, coronary angiography is recommended during the same hospitalization.
我们评估了46例不稳定型心绞痛（UA）患者，这些患者在胸痛发作期间心率、血压和双乘积（作为氧需求增加的证据）无显著变化。所有患者均在同一住院期间进行了冠状动脉造影。在26例伴有ST段压低的UA患者（A组）中，10例患有左主干冠状动脉疾病（CAD），8例患有左主干等同CAD。在20例伴有ST段抬高的UA患者（B组）中，只有1例患有左主干CAD，1例患有左主干等同CAD。A组所有患者V4和V5导联出现ST段压低，B组所有患者V2和V3导联出现ST段抬高。在无氧需求增加证据的UA患者中，V4和V5导联出现ST段压低可能提示存在严重的左主干或左主干等同CAD。因此，建议在同一住院期间进行冠状动脉造影。
