Alegría E, Elizalde J M, Malpartida F, Vallés V, Téllez J, Martínez Caro D
Arch Inst Cardiol Mex. 1981 Sep-Oct;51(5):443-52.
Eight patients with typical Prinzmetal's angina and angiography proven coronary artery spasm are reviewed. In all cases the angina pain appeared at rest and was accompanied by a simultaneous ST-segment elevation. The coronary angiography results varied from severe multivessel disease (3 cases) to single vessel disease (3 cases), and normal coronary arteries (2 cases). In all patients a coronary spasm was documented, in five cases induced by ergonovine and in three spontaneously; in all patients but in one, the localization of the spasm was concordant with the ST-segment elevation localization. One case with a severe proximal left anterior descending stenosis was grafted; however the pain was not relieved despite treatment with large amounts of propranolol. This patient died after an episode of severe chest pain. Treatment with nifedipine was given to six patients, with excellent results in four cases, and regular response in two. The main physiopathologic diagnostic and therapeutic aspects of the variant angina syndrome are reviewed.
回顾了8例典型的变异型心绞痛且经血管造影证实有冠状动脉痉挛的患者。所有病例中，心绞痛均在静息时发作，并伴有ST段同时抬高。冠状动脉造影结果从严重的多支血管病变（3例）到单支血管病变（3例）以及冠状动脉正常（2例）不等。所有患者均记录到冠状动脉痉挛，5例由麦角新碱诱发，3例为自发发生；除1例患者外，所有患者痉挛的部位与ST段抬高的部位一致。1例左前降支近端严重狭窄的患者接受了移植手术；然而，尽管使用了大量普萘洛尔治疗，疼痛仍未缓解。该患者在一次严重胸痛发作后死亡。6例患者接受了硝苯地平治疗，4例效果极佳，2例有规律反应。本文对变异型心绞痛综合征的主要病理生理、诊断和治疗方面进行了综述。
