雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

A Case of Vasospastic Angina Associated with Moderately Organic Stenosis Presented Transient Collateral during Coronary Spasm Kohko Yamazaki 1 , Naoki Funayama 1 , Naka Sakamoto 1 , Kenjiro Kikuchi 2 1Division of Cardiology, Hokkaido Circulation Hospital 2First Department of Internal Medicine, Asahikawa Medical College Keyword: 一過性側副血行路 , 冠攣縮性狭心症 , 血管内超音波 , transient collateral , vasospastic angin intravascular ultrasound pp.637-641
Published Date 2002/6/15
DOI https://doi.org/10.11477/mf.1404902493
  • Abstract
  • Look Inside

A 59-year-old female was admitted to our hospital due to anginal attacks while resting in the morning. Vasospastic angina was suspected because of these symptoms. Coronary arteriogram revealed a 75% fixed organic stenosis of the middle portion of the right coronary artery (RCA). Provocative coronary angiogra-phy was attempted, using ergonovine maleate (10μg) , to induce coronary artery spasm. The coronary arterio-gram revealed total occlusive spasm in an organic lesion wihtout chest pain and ST segment changes. Simultaneously, the left coronary arteriogram revealed well-developed collateral blood from the left coronary artery (LCA) to the middle portion of the RCA. After intracoronary administration of isosorbide dinitrate, the right coronary arteriogram showed release of the oc-clusive spasm, and the collateral vessels from the LCA had disappeared. By intravascular ultrasound (IVUS), we recognized plaque deposit on the vessel wall, and not only just an organic lesion but also a long lesion nearly. Coronary intervention may be important to prevent acute coronary syndrome in vasospastic angina with organic stenosis. The IVUS findings played an impor-tant role in determining whether we should attempt stent implantation or not. We selected medical treat-ment after considering the IVUS findings in this case. We were able to recognize neither ischemic change on ECG nor anginal symptom, in spite of total occlusive spasm. This suggests that the well-developed transient collateral flow that was augmented by organic stenosis and frequent anginal attacks, was able to prevent myocardial ischemia.


Copyright © 2002, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

関連文献

もっと見る

文献を共有