Toyama Y, Tanaka H, Nuruki K, Shirao T
Angiology. 1979 Mar;30(3):211-8. doi: 10.1177/000331977903000311.
Prinzmetal's variant of angina occurred in a 48-year-old man who sustained two attacks of subarachnoid hemorrhage within 10 days. The first anginal pain started at the same time that the second cerebrovascular accident developed, but subsequent anginal episodes were not accompanied by other symptoms or signs that indicated new development of subarachnoid hemorrhage. Twelve days later, when nuchal rigidity was fairly improved, the episodes of chest pain ended. A vasospasm of the large coronary arteries--probably due to the derangement of the autonomic nervous system caused by subarachnoid hemorrhage--was presumed to contribute to the occurrence of the variant angina. Based on this case and on review of the literature, we propose that coronary arterial spasm is one of several causes of the cardiac changes seen in subarachnoid hemorrhage.
一名48岁男性发生了变异型心绞痛，该患者在10天内出现了两次蛛网膜下腔出血发作。首次心绞痛发作与第二次脑血管意外同时开始，但随后的心绞痛发作并未伴有提示蛛网膜下腔出血新发病变的其他症状或体征。12天后，当颈部强直明显改善时，胸痛发作结束。推测大冠状动脉的血管痉挛——可能是由于蛛网膜下腔出血引起的自主神经系统紊乱——促成了变异型心绞痛的发生。基于该病例并经文献复习，我们提出冠状动脉痉挛是蛛网膜下腔出血时所见心脏改变的几种原因之一。
