Levene D L, Freeman M R
JAMA. 1976 Aug 30;236(9):1018-22.
Selective coronary arteriography performed on a 41-year-old woman with angina pectoris demonstrated proximal stenosis of the right and left main coronary arteries that was unaffected by nitrate therapy. To exclude coronary artery spasm, the study was repeated, and a striking increase in the narrowing of the right coronary artery was observed. This 90% stenosis was virtually abolished by pretreatment with intravenously given phentolamine hydrochloride. Prolonged alpha-adrenoceptor blockade with phenoxybenzamine hydrochloride improved the patient's exercise tolerance and postexercise electrocardiographic abnormalities when compared to therapy in matched controls given placebo. These observations suggest that alpha-adrenoceptor-mediated coronary artery spasm may mimic organic lesions at coronary arteriography and may be a factor in the pathogenesis of angina pectoris in some patients.
对一名41岁患有心绞痛的女性进行选择性冠状动脉造影显示，右冠状动脉和左冠状动脉主干近端狭窄，硝酸酯类治疗对此无效。为排除冠状动脉痉挛，重复进行了该检查，结果观察到右冠状动脉狭窄显著加重。静脉注射盐酸酚妥拉明预处理后，这种90%的狭窄几乎消失。与给予安慰剂的匹配对照组相比，用盐酸酚苄明进行长时间的α-肾上腺素能受体阻滞可改善患者的运动耐量和运动后心电图异常。这些观察结果表明，α-肾上腺素能受体介导的冠状动脉痉挛在冠状动脉造影时可能模拟器质性病变，并且可能是某些患者心绞痛发病机制中的一个因素。
