Hattori R, Takatsu Y, Yui Y, Nonogi H, Kawai C
Br Heart J. 1984 Mar;51(3):312-5. doi: 10.1136/hrt.51.3.312.
Unusual vasomotor responses in the coronary arteries occurred in two patients after the administration of glyceryl trinitrate to relieve spasm induced by ergonovine maleate. In one patient after treatment with glyceryl trinitrate and despite dilatation of the adjoining segments a new severe reduction in diameter occurred distally to the segments of the right coronary artery where the ergonovine induced spasm developed. In the other patient the left anterior descending artery filled very slowly after the completely occlusive spasm of the right coronary artery had resolved with glyceryl trinitrate though the circumflex did not. These vasomotor changes were associated with chest discomfort and electrocardiographic abnormalities in both cases. These findings indicate that caution is needed when performing provocative tests even after the ergonovine induced spasm has been reversed with glyceryl trinitrate.
两名患者在使用硝酸甘油缓解马来酸麦角新碱诱发的痉挛后，冠状动脉出现了异常的血管运动反应。在一名患者中，使用硝酸甘油治疗后，尽管相邻节段扩张，但在右冠状动脉麦角新碱诱发痉挛的节段远端，直径出现了新的严重缩小。在另一名患者中，右冠状动脉完全闭塞性痉挛用硝酸甘油缓解后，左前降支动脉充盈非常缓慢，而回旋支动脉则没有。这两种血管运动变化在两例中均与胸部不适和心电图异常有关。这些发现表明，即使在麦角新碱诱发的痉挛已被硝酸甘油逆转后，进行激发试验时仍需谨慎。
