意識消失発作を主訴とした異型狭心症の1例

Syncopal attacks in variant angina:A case report with marked sinus bradycardia and sinus arrest during the angina

　異型狭心症の発作中に種々の不整脈を生じ意識消失を来たすことはPrinzmetalの原著^1）にもあり，その後いくつかの報告がある^2〜17）。しかし多くは完全房室ブロック，心室頻拍によるもので，著明な洞徐脈，洞停止による例はまれである。我々は，29歳時より意識消失発作を訴え，当初，某医大でてんかんを疑われた症例^14）にホルター心電図を施行し，異型狭心症とそれに伴なう著しい洞徐脈，洞停止と診断したので冠動脈造影所見とあわせ報告する。

Arrhythmias during variant anginal attack are common, but syncopal attacks during that are not so common. Such syncopal attacks are almost always due to complete atrioventricular block or ventricular tachycardia, and those due to marked sinus tachycardia or sinus arrest are rare.

A 32 year-old man was reported complaining syncopal attacks in the mid-night or early morning since the age of 29. His electroencephalogram and routine electrocardiogram were normal and Master double exercise test was negative.