Komukai K, Muto M, Imai K, Hashimoto K, Iwano K, Mogi J, Shibata T, Horie T, Mochizuki S
Department of Cardiology, Saitama Cardiovascular and Respiratory Center, Japan.
Jpn Circ J. 1998 Sep;62(9):704-6. doi: 10.1253/jcj.62.704.
A 72-year-old woman was admitted to our hospital for evaluation of chest pain. Coronary angiography showed a left coronary artery-left ventricle fistula. An acetylcholine provocation test induced vasoconstriction of the right but not the left coronary artery. Her chest pain was not relieved by combined therapy with isosorbide dinitrate, diltiazem and nicorandil. Because of the coronary spasm, beta-blockers could not be used. However, her chest pain was relieved after the administration of a minor tranquilizer. Thus, the patient's chest pain was unlikely to be associated with either the fistula or the coronary spasm.
一名72岁女性因胸痛入院接受评估。冠状动脉造影显示左冠状动脉-左心室瘘。乙酰胆碱激发试验诱发了右冠状动脉而非左冠状动脉的血管收缩。硝酸异山梨酯、地尔硫䓬和尼可地尔联合治疗未能缓解她的胸痛。由于冠状动脉痉挛，无法使用β受体阻滞剂。然而，给予一种小剂量镇静剂后她的胸痛得到缓解。因此，患者的胸痛不太可能与瘘或冠状动脉痉挛有关。
