课件：变异性心绞痛我.ppt

谢谢 J Am Coll Cardiol.?2002 Apr 3;39(7):1120-6.Limited?role?of?coronary?angioplasty?and?stenting?in?coronary?spastic?angina?with?organic?stenosis.Tanabe Y,?Itoh E,?Suzuki K,?Ito M,?Hosaka Y,?Nakagawa I,?Kumakura M. OBJECTIVES: We investigated the efficacy of percutaneous?coronary?intervention (PCI) in patients with?coronary?spastic?angina?(CSA) and severeorganic?stenosis. BACKGROUND: Coronary?spasm occurs at the site of?organic?stenosis?in most patients with CSA and severe?stenosis, whereas multivessel spasm occurs frequently in those with normal?coronary?arteries. The incidence of multivessel spasm and the efficacy of PCI in patients with CSA and severestenosis?have not been fully elucidated. METHODS: Forty-five patients with CSA and severe?stenosis?underwent spasm provocative testing with intracoronary acetylcholine before and 7 +/- 3 months after PCI (20 patients had?angioplasty?and 25 patients had?stenting), when all patients were free of restenosis. RESULTS: Spasm was induced at the site of severe?stenosis?in 30 patients (66.7%) with (n = 12) or without (n = 18) spasm induced in another vessel. In the remaining 15 patients, spasm was induced at a different site in the stenotic vessel and/or in another vessel. Repeat provocative tests were performed in 43 of 45 patients. Although spasm was never induced at exactly the same site of the initial?stenosis?that had been dilated, spasm was induced at a different site in the dilated vessel and/or in another vessel, in 33 (76.7%) of 43 patients. Multivessel spasm occurred in 28 (62.2%) of 45 patients on one or both provocations. CONCLUSIONS: Spasm was frequently induced at a site different from the initial?stenosis, even in the absence of restenosis after PCI. Calcium antagonists should be continued in most patients with CSA who show no restenosis after PCI. 后面内容直接删除就行 资料可以编辑修改使用 资料可以编辑修改使用 资料仅供参考，实际情况实际分析 * * LOGO 如何处理变异型心绞痛 Variant angina 徐征 Case 姚XX Symptom：胸痛（静息）（在院） Risk factors：吸烟史30年