合并危及生命的心律失常的变异型心绞痛患者临床特点

Clinical characteristics of variant angina induced life-threatening cardiac arrhythmias

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 study the clinical characteristics of patients with variant angina induced life-threatening cardiac arrhythmias and analysis their prognosis.Method：Detailed clinical findings and cardiac events were respectively collected for fourteen patients.Result：The incidence of variant angina induced life-threatening cardiac arrhythmias is 8.14%.Typical ST-segments elevation on standard ECG in inferior leads was mostly detected （92.86%）.Multivessel coronary spasm was successively attracked in 3 patients （21.43%）.Coronary angiography showed significant coronary stenoses （50%） in 4 patients.Eleven patients were followed up,one dead,another patient occurrence recurrent angina.Conclusion：Coronary vasospasm can cause life-threatening cardiac arrhythmias.Complete atrioventricular block is the most common arrhythmic complication.