Microvascular angina accompanied by epicardial coronary artery spasm

被引:2
|
作者
Horimoto, M [1 ]
Sakuragi, H [1 ]
Takenaka, T [1 ]
Inoue, H [1 ]
Igarashi, K [1 ]
机构
[1] Chitose City Gen Hosp, Div Cardiol, Chitose, Hokkaido 0668550, Japan
关键词
acetylcholine; coronary flow reserve; amlodipine; nicorandil;
D O I
10.2169/internalmedicine.41.216
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A case of microvascular angina accompanied by coronary artery spasm is described. A 54-year-old woman had anginal pain at rest and during exercise. Both exercise testing and rapid atrial pacing caused significant ST depression in the inferior and all precordial leads. Exercise thallium myocardial scintigraphy was negative despite similar ST depressions. Coronary angiography revealed insignificant stenoses of the left anterior descending coronary artery after the injection of nitrate. Intracoronary acetylcholine provoked diffuse spasm of the artery with concurrent myocardial lactate production. Coronary flow reserve assessed with papaverine was 2.75. The combined use of amlodipine and high-dose nicorandil was effective for the treatment of angina.
引用
收藏
页码:216 / 220
页数:5
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