[Myocardial stunning due to simultaneous multivessel coronary spasms: a review of 5 cases].
[Myocardial stunning due to simultaneous multivessel coronary spasms: a review of 5 cases].
复制标题
多支冠状动脉同时痉挛致心肌顿抑5例分析[J].
作者：
K. Dote;H. Sato;H. Tateishi;T. Uchida;M. Ishihara
报告5例典型心肌顿抑。他们有胸痛和心电图异常匹配的急性心肌梗死（AMI）的症状，但没有冠状动脉狭窄的血管造影（CAG）。在415例连续AMI患者中，这些临床表现的患病率为1.2%。心电图异常各不相同; 4例患者观察到ST段抬高，1例患者出现一过性R波降低，1例患者出现Q波。左室造影表现为心尖段、前壁段和/或前外侧段运动不能，基底段运动亢进。这种运动不能是短暂的，并在7天内消退。CAG显示2例患者出现弥漫性多血管痉挛，麦角新碱给药后还在另外2例患者中观察到。冠状动脉内注射硝酸甘油显示任何患者均无冠状动脉狭窄。
Five patients with typical myocardial stunning were presented. They had chest pain and had electrocardiographic abnormalities matching the symptoms of acute myocardial infarction (AMI) but had no coronary artery stenoses on angiogram (CAG). The prevalence of cases with these clinical manifestations was 1.2% among 415 consecutive AMI patients who were examined invasively. The electrocardiographic abnormalities varied; ST elevations were observed in 4 patients, R waves decreased transiently in one, and Q waves developed in one patient. Typical left ventriculogram (LVG) was akinesis in the apical, diaphragmatic and/or anterolateral segments, but hyperkinesis in the basal segments. This akinesis was transient and resolved in 7 days. CAG revealed diffuse multi-vessel spasms in 2 patients, which were also observed in additional 2 patients after ergonovine administration. The intracoronary administration of nitroglycerin disclosed no coronary artery stenoses in any of the patients.