3例右冠状动脉痉挛致Ⅲ度房室传导阻滞临床分析  

Right Coronary Spasm as a Cause of Three-Degree Atrioventricular Block

作　　者：张庆[1] 曾智[1] 黄德嘉[1] 张立[1] 

机构地区：[1]华西医科大学附属第一医院心内科,四川成都610041

出　　处：《华西医学》2001年第2期164-165,共2页West China Medical Journal

摘　　要：目的 :强调右冠状动脉痉挛可引起Ⅲ度房室传导阻滞。方法 :3例间歇性Ⅲ度房室传导阻滞患者于发作时经 12导联和 (或 )动态心电图记录到ST段上抬。冠脉造影和麦角新碱激发试验证实右冠状动脉痉挛的存在。患者均接受硫氮唑酮为主的药物治疗 ,对冠脉严重病变的 1例行PTCA及支架置入。结果 :分别随访 4～ 12月 ,症状改善 ,未发生黑、晕厥。结论 :冠状动脉痉挛可诱发严重的心律失常 ,钙拮抗剂治疗有效。Objective:To emphasize that right coronary spasm can cause three-degree AVB.Methods:Three patients were recorded by 12-leads ECG and(or)Holter as having ST segment elevation and proceding three-degree AVB.Coronary angiography and ergonovine test comfirmed right artery spasm.All three received drug therapy mainly diltizem,while the one with severe underlying atherosclerotic lesions was performed PTCA and stents implantation.Results:Symptoms have improved with no attacks of syncope in the follow up period of 4～12 months.Conclusions:Coronary spasm can provoke lethal arrhythmia,but be treated effectively with Calcium Channel Blocker.

关 键 词：冠状动脉痉挛 Ⅲ度房室传导阻滞 钙离子拮抗剂 

分 类 号：R541.76[医药卫生—心血管疾病]