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[变异性心绞痛:一种诊断不足的病理情况]

[Vasospastic angina : an underdiagnosed pathology].

作者信息

Baroz Antoine, Musayeb Yazan, Degrauwe Sophie, Roffi Marco, Iglesias Juan F

机构信息

Service de cardiologie, Département de médecine, Hôpitaux universitaires de Genève, 1211 Genève 14.

出版信息

Rev Med Suisse. 2024 Sep 4;20(885):1560-1566. doi: 10.53738/REVMED.2024.20.885.1560.

Abstract

Vasospastic angina (VSA) was first described in 1959 by Myron Prinzmetal as "the variant form of angina pectoris" on the sole basis of medical history and ECG. This condition is currently categorized as an endotype of myocardial infarction without coronary obstruction (Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA)). Diagnostic criteria have been suggested by expert consensus. Provocative testing during coronary angiography is the gold standard test but is rarely used. The clinical presentation is often neglected, and the diagnosis is missed. However, VSA may lead to life-threatening arrhythmias. There are simple and effective therapies that are markedly different from those for the atherosclerotic coronary artery disease.

摘要

1959年,迈伦·普林兹梅尔首次将血管痉挛性心绞痛(VSA)描述为“心绞痛的变异形式”,当时仅依据病史和心电图进行诊断。目前,这种病症被归类为无冠状动脉阻塞的心肌梗死的一种亚型(非阻塞性冠状动脉心肌梗死,MINOCA)。专家共识已提出诊断标准。冠状动脉造影期间的激发试验是金标准检查,但很少使用。其临床表现常常被忽视,导致漏诊。然而,VSA可能会引发危及生命的心律失常。有一些简单有效的治疗方法,与动脉粥样硬化性冠状动脉疾病的治疗方法明显不同。

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