冠状动脉造影正常的急性心肌梗塞

目的 :分析 11例冠脉造影 (CAG)正常的急性心肌梗塞 (AMI)患者的临床特征 ,并探讨其发病机理。方法 :132例临床确诊的AMI于MI后 3— 4周行CAG ,据CAG结果分为冠状动脉正常组 (A组 )和冠状动脉病变组 (B组 )。结果 :132例AMI中 11例CAG正常 ,占 8.3% ;A组与B组相比 :A组明显年轻 ,男性比率明显高于B组 ,除吸烟外 ,其他冠心病主要危险因子相对较少 ,梗塞前心绞痛史显著少于B组 ;A组 11例患者其AMI临床表现、心电图演变与心肌酶变化典型 ,7例尿激酶溶栓再通 ,2例无效 ,2例未溶栓 ;左室造影示A组中室壁瘤发生率高 ,但LVEF高于B组 ;A组 11例患者随访 1年均存活。结论 :AMI可发生于CAG正常的患者 ,其临床症状典型 ,发病趋向于年轻男性 ,除吸烟外 ,其他危险因子相对较少 ,发病机制主要与冠状动脉痉挛 (CAS)和 /或血栓形成有关 ;室壁瘤发生率高 ,可能与侧枝循环不能及时有效建立有关。CAG正常的AMI患者预后好于冠状动脉狭窄的AMI患者

Acute myocardial infarction with normal coronary arteriography

Objective: To analysis the characteristics of acute myocardial infarction (AMI) with normal coronary arteriography (CAG) and elucidate its mechanisms . Methods: 132 patients with AMI underwent CAG in 3-4 weeks after onset and divided into A group (with normal CAG) and B group (with abnormal CAG). Results: 11 AMI with normal CAG accounted for 8.3% (11/32).Significant difference was found in the age ratio of men to women, smoking and other risk factors of coronary disease between A and B group, Incidence of left ventricular psendoaneurysm and LVEF in A group were higher than B.Conclusions: There were typical symptoms and changes of ECG and enzymatic. Relative: lower risk factors of coronary disease apart from smoking in AMI with normal CAG, it was associated with coronary anery spasm and/or thrombus formation, a high incidence of left ventricular psendoaneurysm was related to collateral circulation hadn't made in time. Clinical outcomes of AMI with normal coronary were better than AMI with coronary obstructive.