Department of Cardiology and Angiology, Robert-Bosch-Krankenhaus, Auerbachstr. 110, 70376, Stuttgart, Germany.
Department of Psychosomatic Medicine, Robert-Bosch-Krankenhaus, Stuttgart, Germany.
Herz. 2024 Aug;49(4):277-281. doi: 10.1007/s00059-024-05253-2. Epub 2024 Jun 19.
Patients with angina and unobstructed coronary arteries (ANOCA) are frequently encountered in clinical practice. These cases represent a diagnostic and therapeutic challenge and are often characterized by a long patient journey until a diagnosis of coronary vasomotor disorders is established. Moreover, the unsatisfactory management of such patients leads to insecurity, ongoing symptoms, and psychological sequelae such as anxiety or depression. Currently, the psychological burden in patients with ANOCA is underestimated, underexplored, and undertreated. This review gives a new perspective on the pathophysiology of coronary vasomotor disorders including psychological risk factors and calls for comprehensive care by interdisciplinary ANOCA clinics.
临床上经常会遇到心绞痛且冠状动脉无阻塞（ANOCA）的患者。这些病例构成了诊断和治疗方面的挑战，通常表现为患者需要经历漫长的就诊过程，直到确定为冠状动脉血管舒缩功能障碍的诊断。此外，此类患者的治疗效果不理想会导致其产生不安全感，持续出现症状，并产生焦虑或抑郁等心理后遗症。目前，ANOCA 患者的心理负担被低估、研究不足且治疗不足。本综述从包括心理危险因素在内的冠状动脉血管舒缩功能障碍的病理生理学方面提供了新的视角，并呼吁通过ANOCA 多学科临床团队提供全面的护理。
