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目的:探讨合并危及生命的心律失常的变异型心绞痛患者的临床特点并分析其预后,为该病的防治提供依据。方法:回顾性研究14例合并危及生命的心律失常的变异型心绞痛患者的临床特征,并随访其心脏事件。结果:变异型心绞痛合并危及生命的心律失常发生率为8.14%;诱发因素多为吸烟(92.86%)、ST段抬高的导联显示下壁缺血(92.86%);以心动过缓为主;3例患者出现2支冠状动脉先后发生痉挛(21.43%);冠状动脉造影检查示4例患者冠状动脉狭窄>50%,其中3例患者因痉挛相关的冠状动脉狭窄>80%并行介入治疗;随访的11例患者中1例猝死,1例出现2次心绞痛发作伴Ⅲ度房室传导阻滞。结论:冠状动脉痉挛所致的变异型心绞痛患者会发生危及生命的心律失常,且以高度房室传导阻滞为主。
Objective: To investigate the clinical characteristics of patients with variant angina pectoris and life-threatening arrhythmias and to analyze the prognosis of the patients and provide basis for the prevention and treatment of the disease. Methods: A retrospective study of 14 patients with variant angina with life-threatening arrhythmias was performed and their cardiac events were followed up. Results: The incidence of arrhythmic life threatening arrhythmia in patients with variant angina was 8.14%. Most of the inducing factors were smoking (92.86%). The leads of ST segment elevation showed inferior wall ischemia (92.86%). The main symptom was bradycardia 3 patients had spasm of two coronary arteries (21.43%), coronary angiography showed coronary stenosis (> 40%) in 4 patients, and 3 patients were treated with interventional therapy of spasticity-related coronary stenosis (> 80%). One patient died of sudden death in 11 patients followed up, and one patient developed angina pectoris with degree Ⅲ atrioventricular block. CONCLUSIONS: Patients with variant angina caused by coronary spasm develop life-threatening arrhythmias, with a high degree of atrioventricular block.