Siembab L, Kitliński M, Piwowarska W
Kliniki Choroby Wieńcowej, Instytutu Kardiologii Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.
Przegl Lek. 1995;52(8):395-9.
Current views about etiology, pathogenesis, diagnostics and treatment of coronary artery spasm have been presented. A lot of researches show complexity of factors, which are responsible for coronary artery spasm. The most important are: a local hypersensitivity of vessels wall, neurogenic factors and humoral factors. The lack of magnesium plays also important role. Clinical manifestations of coronary artery spasm are: Printzmetal's angina, arrhythmia, acute myocardial infarction, atypical chest pain and cardiac sudden death. Among diagnostic examination the main importance have provocative tests with ergonovine and acetylcholine, rarely hyperventilation and cold are used. Calcium channel blockers, nitrate, molsidomine are employed in treatment patients with coronary artery spasm. There are taken modern examinations of new drugs like beta-1 adrenergic agonists and derived molsidomine agents. Beta-adrenergic blocking agents are contraindicated. It has been emphasized, that early diagnostics and pharmacologic treatment improve long-term prognosis in this group of patients.
本文介绍了目前关于冠状动脉痉挛的病因、发病机制、诊断和治疗的观点。许多研究表明,导致冠状动脉痉挛的因素很复杂。其中最重要的因素包括:血管壁局部超敏反应、神经源性因素和体液因素。镁缺乏也起着重要作用。冠状动脉痉挛的临床表现有:变异型心绞痛、心律失常、急性心肌梗死、非典型胸痛和心源性猝死。在诊断检查中,麦角新碱和乙酰胆碱激发试验最为重要,很少使用过度通气和冷刺激试验。钙通道阻滞剂、硝酸盐、莫西赛利用于治疗冠状动脉痉挛患者。目前正在对β-1肾上腺素能激动剂和莫西赛利衍生物等新药进行现代研究。β-肾上腺素能阻滞剂禁用。文中强调,早期诊断和药物治疗可改善这类患者的长期预后。