Koiwaya Y, Torii S, Takeshita A, Nakagaki O, Nakamura M
Circulation. 1982 Feb;65(2):275-80. doi: 10.1161/01.cir.65.2.275.
Recurrent ST-segment elevations in leads where new Q waves developed were repeatedly recorded in six patients during a recovery phase of acute myocardial infarction. Such ST-segment elevations were transient, occurred with or without chest pain, and returned to control levels. No enzymatic changes signifying recurrent myocardial necrosis were found after each episode. Selective coronary cineangiography in one patient demonstrated a mild segmental stenosis in the coronary artery perfusing the infarcted area; this artery became completely occluded after administration of i.v. ergonovine. Administration of calcium antagonists effectively reduced the frequency of postinfarction angina and ST-segment elevations. The clinical features suggest that the postinfarction angina in these patients is produced by coronary arterial spasm and that coronary arterial spasm may cause severe life-threatening dysrhythmias.
在急性心肌梗死恢复期，6例患者反复记录到新出现Q波导联的ST段反复抬高。这种ST段抬高是短暂的，有无胸痛均可出现，并恢复至对照水平。每次发作后均未发现提示心肌坏死复发的酶学变化。1例患者的选择性冠状动脉造影显示，梗死区域供血冠状动脉有轻度节段性狭窄；静脉注射麦角新碱后该动脉完全闭塞。给予钙拮抗剂可有效减少梗死后心绞痛发作频率和ST段抬高。临床特征提示，这些患者的梗死后心绞痛是由冠状动脉痉挛所致，冠状动脉痉挛可能导致严重的危及生命的心律失常。
