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冠状动脉痉挛(CAS)已是人们熟悉的概念。但是,CAS时心室活动变化和CAS缓解再灌注后心室功能恢复及影响因素仍需进一步研究。通过研究我们可以探索CAS影响心室活动的病理生理规律及防治方法。 一、CAS时室壁运动、血流动力学和心电图的变化特点 在急性心肌缺血缺氧情况下,心脏最先表现为缺血区室壁的局限性和节段性运动异常,然后是心电图缺血性ST、T改变,在有较大面积室壁运动异常,甚至心室腔扩大时出现血流动力学异常。表现为心搏出量下降,动脉压下降,等容收缩时间延长,平均压力变化率升高,EF值下降,左室舒张未压升高,舒张未长轴长度延长,早期充盈量减少,同时可有右室功能异常。
Coronary artery spasm (CAS) is a well-known concept. However, changes in ventricular activity CAS and CAS reperfusion after ventricular recovery and influencing factors still need further study. Through research we can explore the pathophysiology of CAS affect ventricular activity and prevention and treatment methods. First, the CAS when the wall motion, hemodynamics and ECG changes in the characteristics of acute myocardial ischemia and hypoxia, the heart of the first performance of ischemic compartment wall limitations and segmental motor abnormalities, and then the electrocardiogram Ischemic ST, T changes, in a larger area of wall motion abnormalities, even when the ventricular cavity expansion hemodynamic abnormalities. Manifested as decreased cardiac output, arterial pressure, isovolumic contraction time, the average rate of change of pressure increased, EF value decreased, left ventricular diastolic no pressure increased diastolic axis length extension, early filling decreased, at the same time May have right ventricular dysfunction.