冠攣縮性狭心症
WordNet
- suffering from spastic paralysis; "a spastic child"
- a person suffering from spastic paralysis
- relating to or characterized by spasm; "a spastic colon"; "spastic paralysis is a spastic form of cerebral palsy"
- (botany) the trumpet-shaped or cup-shaped outgrowth of the corolla of a daffodil or narcissus flower
- one or more circles of light seen around a luminous object
- a long cigar with blunt ends
- (anatomy) any structure that resembles a crown in shape
- surrounding like a crown (especially of the blood vessels surrounding the heart); "coronary arteries"
- any disease of the throat or fauces marked by spasmodic attacks of intense suffocative pain
PrepTutorEJDIC
- けいれん性麻痺患者
- コロナ(皆既日食のときに見える光冠) / (太陽・月などの)かさ
- 冠状動脈の / 心臓の / 冠状動脈血栓(けっせん)症(coronary thrombosis)
- アンギナ(のどの炎症に関する諸病気) / =angina pectoris
UpToDate Contents
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English Journal
- Rho-associated kinase 2 polymorphism in patients with vasospastic angina.
- Yoo SY, Kim J, Cheong S, Shin DH, Jang J, Lee C, Tahk SJ, Shin JH, Choi SY, Yoon MH.SourceDivision of Cardiology, Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Korea.
- Korean circulation journal.Korean Circ J.2012 Jun;42(6):406-13. Epub 2012 Jun 28.
- BACKGROUND AND OBJECTIVES: Recent studies indicate that in response to vasoconstrictor stimuli, the small GTPase RhoA and its down-stream effector, Rho-associated kinase 2 (ROCK)/Rho-kinase, are associated with hypercontraction of the vascular smooth muscle of coronary arteries through augmentation
- PMID 22787471
- In vivo assessment of ergonovine-induced coronary artery spasm by 64-slice multislice computed tomography.
- Ito T, Terashima M, Kaneda H, Nasu K, Ehara M, Kinoshita Y, Ito T, Kimura M, Tanaka N, Habara M, Tsuchikane E, Suzuki T.SourceToyohashi Heart Center, Toyohashi, Japan. tito@heart-center.or.jp
- Circulation. Cardiovascular imaging.Circ Cardiovasc Imaging.2012 Mar;5(2):226-32. Epub 2012 Feb 16.
- BACKGROUND: The potential of multislice CT (MSCT) to predict coronary spasm has not been elucidated. The aim of this study was to investigate whether the morphological features observed on MSCT at the site of ergonovine-induced epicardial spasm could be used as diagnostic criteria for coronary spasm
- PMID 22342944
Japanese Journal
- Guidelines for Diagnosis and Treatment of Patients With Vasospastic Angina (Coronary Spastic Angina) (JCS 2013) : Digest Version
- JCSJointWorkingGroup
- Circulation journal : official journal of the Japanese Circulation Society 78(11), 2779-2801, 2014-11
- NAID 40020238413
- 病気について知りたい! 臨床講座(65)狭心症(冠攣縮性狭心症・労作性狭心症)
- Differences and Interactions between Risk Factors for Coronary Spasm and Atherosclerosis -Smoking, Aging, Inflammation, and Blood Pressure-
- Morita Sumio,Mizuno Yuji,Harada Eisaku,Nakagawa Hitoshi,Morikawa Yoshinobu,Saito Yoshihiko,Katoh Daisuke,Kashiwagi Yusuke,Yoshimura Michihiro,Murohara Toyoaki,Yasue Hirofumi
- Internal Medicine 53(23), 2663-2670, 2014
- … Objective Coronary spasm as well as atherosclerosis plays an important role in the pathogenesis of coronary heart disease. … However, the relationship between coronary spasm and atherosclerosis is not well known. … The purpose of the present study was to examine the differences and interactions between risk factors for coronary spasm and atherosclerosis and thereby explore the pathogenesis of coronary spasm. …
- NAID 130004713268
Related Links
- Case Report Silent coronary spastic angina: A report of a case Shozo Sueda (MD, FJCC)*, Yasuhiro Sasaki (MD), Hirokazu Habara (MD), Hiroaki Kohno (MD) Department of Cardiology, Ehime Niihama Prefectural Hospital, Ehime ...
- 1. Circ J. 2004 Apr;68(4):367-70. Coronary spastic angina in patients with connective tissue disease. Soejima H(1), Miyamoto S, Kojima S, Hokamaki J, Tanaka T, Kawano H, Sugiyama S, Sakamoto T, Yoshimura M, Kishikawa H ...
★リンクテーブル★
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- 英
- coronary spastic angina, CSA
- 同
- 冠れん縮性狭心症
- 関
- 狭心症
概念
- 狭心症の発生機序による分類であって、冠攣縮に基づく心筋虚血による狭心症。下位疾患概念として異型狭心症がある(ST elevationがatypical)。
- 冠攣縮に基づく心筋虚血による狭心症であって、心電図変化は問わない(でよろしい? ∵異型狭心症「冠攣縮性狭心症であって、安静時の狭心発作に可逆性一過性のST上昇を伴う狭心症(YN.C-68)」)
- 明け方に起こることが多い。
病因
- あまりよく分かっていない。
- 夜間から早朝にかけての副交感神経亢進時、つまり交感神経と副交感神経の活動が激しく入れ替わるときに多い。(ECGP.175)
- 血管内皮機能の異常(Achにより正常であれば血管が弛緩するところであるが、血管内皮に異常がある場合血管が収縮する) + 種々の程度の冠動脈硬化 → 冠攣縮による冠血流の低下
誘因
- 喫煙、精神的ストレス、飲酒(醒めかけ)、運動(早朝から午前に多い。運動誘発性。運動開始時に起こり、運動を続けると消失)
- 喫煙により体内に生じた活性酸素が内皮障害を引き起こしNOの産生障害をきたす。
- 運動誘発性の場合、多枝攣縮が多く、致死性不整脈を生じやすく、突然死の危険が高い。(ECGP.175)
診断
- 心電図:
ST上昇????? YNの定義に基づけば間違っている
治療
- 発作時:ニトログリセリン舌下錠
- 予防 :長時間作用型の硝酸薬、カルシウム拮抗薬
参考
- 1. 冠攣縮性狭心症の診断と治療に関するガイドライン2008
- http://www.j-circ.or.jp/guideline/pdf/JCS2008_ogawah_h.pdf
国試
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- 関
- convulsive、cramp、muscle spasticity、spasmodic、spasticity
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- 関
- coronary artery、coronary vessel
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コロナ帯