Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye.
Turk Kardiyol Dern Ars. 2023 Sep;51(6):415-418. doi: 10.5543/tkda.2023.73858.
Coronary vasospasm is characterized by transient and reversible vasoconstriction that can cause myocardial ischemia. Patients with acute coronary syndrome may present to the emergency department with various clinical features, including mortal arrhythmias and cardiac arrest. Coronary angiography was performed in a 61-year-old male patient with the diagnosis of acute coronary syndrome due to recurrent angina attacks and dynamic changes in electrocardiography. In the patient whose critical stenosis was not detected in the first imaging, angina attack developed before the procedure was terminated. On control imaging, we detected total occlusion of the left anterior descending artery due to coronary vasospasm. After the administration of intracoronary nitroglycerin, the total occlusion of the left anterior descending artery due to vasospasm completely resolved and the angina attack relieved. It is uncommon for total stenosis to develop immediately after the coronary angiography observes open coronary arteries. However, if total stenosis is detected in patients with recurrent angina attacks without risk factors, intracoronary nitroglycerin can be administered to appropriate patients before intervention.
冠状动脉痉挛的特征是短暂和可逆的血管收缩，可导致心肌缺血。患有急性冠状动脉综合征的患者可能会因各种临床特征而到急诊科就诊，包括致命性心律失常和心脏骤停。对一名 61 岁男性患者进行了冠状动脉造影，该患者因反复心绞痛发作和心电图动态变化而被诊断为急性冠状动脉综合征。在首次影像学检查未发现严重狭窄的患者中，在手术结束前出现了心绞痛发作。在对照影像学检查中，我们发现由于冠状动脉痉挛导致前降支完全闭塞。给予冠状动脉内硝酸甘油后，由于血管痉挛导致的前降支完全闭塞完全缓解，心绞痛得到缓解。在冠状动脉造影观察到开放的冠状动脉后，立即发生完全狭窄并不常见。但是，如果在没有危险因素的情况下，反复出现心绞痛发作的患者检测到完全狭窄，可以在介入治疗前向合适的患者给予冠状动脉内硝酸甘油。
