Stiesmeyer J K
Camino Hospital Education and Training, Mountain View, CA 94039-7025.
Am J Crit Care. 1993 Jan;2(1):48-53.
A critical proximal left anterior descending coronary artery stenosis associated with unstable angina places a patient at extreme risk for extensive anterolateral myocardial damage with potentially irreversible hemodynamic demise. Characteristics of this pathology are a clinical profile of new-onset unstable angina, normal or minimally elevated cardiac enzymes, and 12-lead electrocardiographic indicators specific for anterolateral ischemia usually seen in periods when the patient is pain-free. Knowledge of this profile, administration and evaluation of pharmacologic therapies and a unique bedside monitoring strategy with hourly surveillance of the precordial leads are key measures necessary to stabilize and preserve the integrity of myocardial tissue until aggressive, invasive revascularization therapies are instituted.
左前降支冠状动脉近端严重狭窄伴不稳定型心绞痛，会使患者面临发生广泛前外侧心肌损伤的极高风险，可能导致不可逆转的血流动力学衰竭。这种病理情况的特征包括新发不稳定型心绞痛的临床表现、心肌酶正常或轻度升高，以及通常在患者无痛期出现的、提示前外侧缺血的12导联心电图指标。了解这种情况、应用和评估药物治疗，以及采用独特的床边监测策略，每小时监测胸前导联，是在采取积极的有创血运重建治疗之前，稳定并维持心肌组织完整性的关键措施。
