Department of Medicine, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA.
Department of Cardiology, Westchester Medical Center & New York Medical College, Valhalla, NY 10595, USA.
Future Cardiol. 2024;20(11-12):613-618. doi: 10.1080/14796678.2024.2392995. Epub 2024 Sep 4.
Coronary vasospasm can lead to decreased cardiac perfusion and result in acute coronary syndrome. Here is a case of a 49-year-old man presented to the emergency department with epigastric pain and nausea with normal initial electrocardiogram. However, 6 h later, the patient experienced severe chest pain prompting a repeat electrocardiogram demonstrating inferior ST-segment elevation with troponin I levels peaked at 1.2 ng/ml (normal range: 0.00-0.02 ng/ml). Coronary angiography revealed angiographic stenosis in the left circumflex territory of a left dominant system which resolved with intracoronary nitroglycerin administration indicating ischemia with nonobstructive coronary arteries secondary to coronary vasospasm. He was discharged on isosorbide mononitrate and amlodipine therapy and had no recurrence of symptoms during follow-up.
冠状动脉痉挛可导致心肌灌注减少，进而引发急性冠状动脉综合征。现介绍 1 例 49 岁男性患者，因上腹痛和恶心就诊于急诊科，初始心电图正常。然而，6 小时后，患者出现严重胸痛，再次行心电图检查示下壁 ST 段抬高，肌钙蛋白 I 峰值达 1.2ng/ml（正常值：0.00-0.02ng/ml）。冠状动脉造影显示左优势型系统的左旋支存在血管造影狭窄，给予冠状动脉内硝酸甘油后狭窄缓解，提示非阻塞性冠状动脉病变所致的缺血性冠状动脉痉挛。出院时给予单硝酸异山梨酯和氨氯地平治疗，随访期间无症状复发。
