Misumi I, Tsuruta K, Tanae H, Sakamoto T, Tsunoda R, Sakano S, Tanaka M
Department of Cardiology, Juzen Hospital.
Kokyu To Junkan. 1993 Nov;41(11):1101-5.
A 59-year old female who complained of chest discomfort was admitted to our hospital. Electrocardiogram (ECG) on admission and treadmill exercise test showed negative for ischemia. She underwent coronary arteriography. Initial angiography showed there was no significant coronary arterial stenosis. However, when we were preparing the spasm provocation test, she complained of the same kind of chest discomfort as she had felt before. We found that ST segment was elevated in both the anterior and inferior leads on the ECG. Coronary arteriography showed that severe spasm occurred in both the left anterior descending artery (Seg. 6) and the right coronary artery (Seg. 1). Heart rate decreased and electromechanical dissociation occurred. She temporarily lost consciousness. After cardiopulmonary resuscitation, she recovered and the elevation of ST segment returned on the ECG. This is the first case report which has documented spontaneous simultaneous multivessel coronary spasm by coronary arteriography.
一名主诉胸部不适的59岁女性入住我院。入院时心电图（ECG）及平板运动试验显示缺血阴性。她接受了冠状动脉造影。初次血管造影显示无明显冠状动脉狭窄。然而，当我们准备痉挛激发试验时，她诉说出现了与之前相同类型的胸部不适。我们发现心电图上的前壁和下壁导联ST段均抬高。冠状动脉造影显示左前降支（第6段）和右冠状动脉（第1段）均发生严重痉挛。心率下降并出现电机械分离。她暂时失去意识。经过心肺复苏，她恢复了意识，心电图上ST段抬高也恢复了。这是首例通过冠状动脉造影记录到自发性同时多支冠状动脉痉挛的病例报告。
