Syndrome Xと思われる49歳の女性にみられた左冠状動脈主幹部の攣縮

Spasm of the left main coronary artery observed in a 49 year-old female with syptoms and signs of Syndrome-X

　Syndrome Xは，正常の冠状動脈造影を示す狭心症症例に対してつけられた名称であるが，その発現機序に関して，種々の報告がなされてきた。我々は冠状動脈造影とタリウム心筋灌流スキャンで，それぞれ左冠状動脈主幹部の攣縮と，それに相当する心筋部位の冠血流障害をうかがわせた貴重な症例を観察したので報告する。

A 49-year-old woman had begun to experience chest pain during physical exertion two years previously. She showed marked S-T segment depression of 0.3 m V in lead I, II, aVL, aVF, and V3 to V6 at the time of the attack. Sublingual administration of nitroglycerine shortened the duration of pain and improved S-T segment de-pression within 3 minites.

A selective left coronary angiography showed obstruction at the left maintruncs. The right coronary artery was normal.