Wiener L, Kasparian H, Duca P R, Walinsky P, Gottlieb R S, Hanckel F, Brest A N
Am J Cardiol. 1976 Dec;38(7):945-55. doi: 10.1016/0002-9149(76)90808-0.
A relationship of coronary arterial spasm to variant angina pectoris, subendocardial ischemia, major ventricular arrhythmias and myocardial infarction has been demonstrated. In 29 patients, spasm was angiographically observed in normal-appearing coronary arteries (7 patients) as well as superimposed on various degrees of coronary atherosclerotic obstruction (22 patients). All patients experienced an atypical anginal syndrome;16 patients also experienced typical exertional angina. Coronary spasm appeared to be a major contributory factor in eight occurrences of myocardial infarction and in 11 incidents of ventricular tachycardia, ventricular fibrillation and heart block. Coronary spasm in the 29 cases was distributed in the following fashion: left main trunk, 6 cases; right main trunk, 12 cases; proximal left anterior descending artery, 13 cases; proximal circumflex artery, 1 case; distal left anterior descending artery, 1 case; and distal circumflex artery, 2 cases. In 5 cases coronary spasm was noted at multiple sites.
冠状动脉痉挛与变异型心绞痛、心内膜下缺血、严重室性心律失常及心肌梗死之间的关系已得到证实。在29例患者中，血管造影观察到正常冠状动脉出现痉挛（7例）以及不同程度的冠状动脉粥样硬化阻塞基础上发生痉挛（22例）。所有患者均有非典型心绞痛综合征；16例患者还出现典型劳力性心绞痛。冠状动脉痉挛似乎是8例心肌梗死以及11例室性心动过速、心室颤动和心脏传导阻滞事件的主要促成因素。29例患者的冠状动脉痉挛分布如下：左主干6例；右主干12例；左前降支近端13例；回旋支近端1例；左前降支远端1例；回旋支远端2例。5例患者在多个部位出现冠状动脉痉挛。
