Andy Wang, Juliet Meir, Aaqib Malik, Tzvi Fishkin, Subo Dey, Julio A Panza, Syed Haidry
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引用次数: 0
摘要
冠状动脉血管痉挛可导致心脏灌注减少,引发急性冠状动脉综合征。这里有一个病例,一名 49 岁的男子因上腹疼痛和恶心到急诊科就诊,最初心电图正常。然而,6 小时后,患者出现剧烈胸痛,再次做心电图显示下行 ST 段抬高,肌钙蛋白 I 水平达到峰值 1.2 纳克/毫升(正常范围:0.00-0.02 纳克/毫升)。冠状动脉造影显示,左侧优势系统的左侧环状区血管狭窄,冠状动脉内注射硝酸甘油后症状缓解,表明冠状动脉血管痉挛继发非阻塞性冠状动脉缺血。他出院后接受了单硝酸异山梨酯和氨氯地平治疗,随访期间症状没有复发。
Acute coronary syndrome due to coronary vasospasm: a case report.
Coronary vasospasm can lead to decreased cardiac perfusion and result in acute coronary syndrome. Here is a case of a 49-year-old man presented to the emergency department with epigastric pain and nausea with normal initial electrocardiogram. However, 6 h later, the patient experienced severe chest pain prompting a repeat electrocardiogram demonstrating inferior ST-segment elevation with troponin I levels peaked at 1.2 ng/ml (normal range: 0.00-0.02 ng/ml). Coronary angiography revealed angiographic stenosis in the left circumflex territory of a left dominant system which resolved with intracoronary nitroglycerin administration indicating ischemia with nonobstructive coronary arteries secondary to coronary vasospasm. He was discharged on isosorbide mononitrate and amlodipine therapy and had no recurrence of symptoms during follow-up.
期刊介绍:
Research advances have contributed to improved outcomes across all specialties, but the rate of advancement in cardiology has been exceptional. Concurrently, the population of patients with cardiac conditions continues to grow and greater public awareness has increased patients" expectations of new drugs and devices. Future Cardiology (ISSN 1479-6678) reflects this new era of cardiology and highlights the new molecular approach to advancing cardiovascular therapy. Coverage will also reflect the major technological advances in bioengineering in cardiology in terms of advanced and robust devices, miniaturization, imaging, system modeling and information management issues.