Department of Cardiology, NHO Hiroshimanishi Medical Center, Japan.
Intern Med. 2024 May 15;63(10):1377-1380. doi: 10.2169/internalmedicine.2413-23. Epub 2023 Oct 6.
A 90-year-old man experienced chest oppressive sensation at 12:30 AM for the first time. Electrocardiography showed a newly developed inversion of the terminal T-wave in the V leads. A left coronary angiogram showed no significant atherosclerotic stenosis. A myocardial bridge was found in the mid-left anterior descending artery (LAD). Myocardial scintigraphy with I beta-methyl 15-para-iodophenyl 3(R,S)-methylpentadecanoic acid revealed a reduced uptake in the apical and septal areas. Based on these findings, we suspected new-onset vasospastic angina complicated by a myocardial bridge in the territory of the LAD. He remained in good condition without recurrent anginal attacks after nifedipine was started before bedtime.
一位 90 岁男性于凌晨 12:30 首次出现胸闷感。心电图显示 V 导联的终末 T 波出现新的倒置。左冠状动脉造影显示无明显动脉粥样硬化狭窄。在左前降支中段发现心肌桥。I β-甲基 15-对碘苯 3(R,S)-甲基十五烷酸心肌闪烁显像显示心尖和室间隔摄取减少。基于这些发现,我们怀疑新发的血管痉挛性心绞痛并发左前降支区域的心肌桥。硝苯地平睡前开始后,他状况良好,无再发心绞痛。