Ruwitch J R, Ludbrook P A, Sobel B E
Adv Cardiol. 1977;20:27-40. doi: 10.1159/000399851.
Angina with "normal coronary arteries" might best be thought of as "angina with coronary dysfunction". It seems likely that this syndrome is due to inadequate regional myocardial perfusion with manifestations similar to those seen when ischemia results from occlusive coronary artery disease. The prognosis of the disorder is favorable, but occasional catastrophic events occur. It appears likely that maldistribution of perfusion results from dynamic changes affecting proximal, and perhaps distal coronary vessels, potentially mediated by vasoactive substances released from platelets precipitating or exacerbating coronary arterial spasm. Clarification of the pathogenesis of the syndrome should permit implementation of more effective therapy and prevention of the rare malignant sequelae of this disorder.
“冠状动脉正常”的心绞痛最好被视为“冠状动脉功能障碍性心绞痛”。这种综合征似乎是由于局部心肌灌注不足所致，其表现与冠状动脉闭塞性疾病导致缺血时所见的表现相似。该疾病的预后良好，但偶尔会发生灾难性事件。灌注分布不均似乎是由影响冠状动脉近端甚至远端血管的动态变化引起的，这些变化可能由血小板释放的血管活性物质介导，从而引发或加剧冠状动脉痉挛。阐明该综合征的发病机制应有助于实施更有效的治疗，并预防该疾病罕见的恶性后遗症。
