Reversible ischemia on treadmill exercise in left main coronary artery vasospasm

作     者：HUNG Ming-yow CHANG Nen-chung HUNG Ming-jui 

作者机构：Division of Cardiology Department of Internal Medicine Shuang Ho Hospital Taipei Medical University Taipei 235 Taiwan China Department of Internal Medicine School of Medicine College of Medicine Taipei Medical University Taipei 110 Taiwan China Division of Cardiology Department of Internal Medicine Taipei Medical University Hospital Taipei 110 Taiwan China Department of Cardiology Chang Gung Memorial Hospital Keelung Chang Gung University College of Medicine Keelung city 20401 Taiwan China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2011年第124卷第24期

页      面：4364-4367页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：ischemia treadmill left main coronary artery coronary vasospasm 

摘      要：Coronary vasospasm of the left main coronary artery （LMCA） is a rare condition with potentially devastating consequences. We present 2 patients with LMCA vasospasm-related angina, the first being a 46-year-old woman and the second a 51-year-old woman. Both of them developed ST-segment ischemic changes on treadmill exercise tests. Coronary angiography showed spontaneous LMCA vasospasm in one patient and methylergonovine-induced LMCA vasospasm in the other patient. Follow-up treadmill exercise tests revealed no exercise-induced ischemia after calcium antagonist monotherapy. These cases demonstrate the importance of identifying LMCA vasospasm, as the treatment of choice varies in patients with angina pectoris. Reversible myocardial ischemia caused by LMCA vasospastic angina can be controlled by calcium antagonist monotherapy and detected by repeat non-invasive stress testing.