Conti C R, Feldman R L, Pepine C J
Am Heart J. 1982 Apr;103(4 Pt 2):584-8. doi: 10.1016/0002-8703(82)90461-6.
Recent clinical and laboratory observations indicate that coronary artery spasm may play a role in the pathophysiology of ischemic heart disease. The majority of patients with ischemic heart disease have coronary atherosclerosis. The prevalence of coronary artery spasm in these patients is unknown. However, current evidence suggests that patients with rest angina have a higher incidence of coronary artery spasm than do patients with reproducible effort angina. Coronary artery spasm may initiate or contribute to acute myocardial infarction, but recent evidence obtained in patients undergoing thrombolytic therapy during the early phases of myocardial infarction suggests that it is not a common occurrence. Although numerous examples of ventricular tachycardia and ventricular fibrillation occur during episodes of coronary artery spasm, the incidence of coronary artery spasm in association with sudden death is unknown. Provocative testing with ergonovine maleate reveals that the highest incidence of provocable coronary artery spasm is found in patients with rest angina. In patients with the syndrome of variant angina, coronary artery spasm is nearly always provocable.
近期的临床和实验室观察表明，冠状动脉痉挛可能在缺血性心脏病的病理生理学中起作用。大多数缺血性心脏病患者患有冠状动脉粥样硬化。这些患者中冠状动脉痉挛的患病率尚不清楚。然而，目前的证据表明，静息性心绞痛患者冠状动脉痉挛的发生率高于可重复性劳力性心绞痛患者。冠状动脉痉挛可能引发或促成急性心肌梗死，但近期在心肌梗死早期接受溶栓治疗的患者中获得的证据表明，这种情况并不常见。尽管在冠状动脉痉挛发作期间有许多室性心动过速和心室颤动的例子，但冠状动脉痉挛与猝死相关的发生率尚不清楚。用马来酸麦角新碱进行激发试验显示，静息性心绞痛患者中可诱发冠状动脉痉挛的发生率最高。在变异型心绞痛综合征患者中，冠状动脉痉挛几乎总是可诱发的。
