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此病为左冠脉主干狭窄50%以上,它比冠脉其它部位狭窄75%以上的预后更为不良。是缺血性心脏病中需特别注意的疾病。原因:多为冠脉粥样硬化所致。在这种情况下,单纯左主干狭窄少,多伴有其它支严重的弥漫性病变。在少见情况下,也可由梅毒性大动脉炎、栓塞和结节性动脉周围炎所引起。自觉症状:此病90%以上有胸痛,多为增恶型和初发型心绞痛,20～40%呈现不稳定型心绞痛。常诉呼吸困难。X线所见:可见左冠脉主干钙化,但钙化并不说明狭窄部位和程度。心电图表现:80%安静时心电图可见ST-T改变,但多数为非特异性。运动试验心电图的特点是心率在120次/分以下时,即出现ST—T改变,若在12导联心电图中,运动后有5个导联呈缺血性ST降低2mm以上,且持续6分钟以上,诊断左主干狭窄的敏感性为74%,预期值为32%。
The disease is more than 50% of the main stenosis of the left coronary artery, which is worse than the prognosis of more than 75% of the stenosis in other parts of the coronary artery. It is a disease that needs special attention in ischemic heart disease. Cause: mostly caused by coronary atherosclerosis. In this case, the simple left main stenosis less often accompanied by other branches of serious diffuse disease. In rare cases, but also by the syphilitic aortitis, embolism and nodular periarteritis caused. Symptoms: more than 90% of the disease have chest pain, mostly increased and early onset angina, 20 ~ 40% showed unstable angina. Often complained of dyspnea. X-ray findings: visible coronary calcification of the left coronary artery, but calcification does not indicate the location and extent of stenosis. ECG performance: ST-T changes in electrocardiogram at 80% rest, but most are nonspecific. Exercise test electrocardiogram is characterized by heart rate at 120 beats / min or less, that appear ST-T changes, if the 12-lead ECG, 5 leads after exercise were ischemic ST reduced more than 2mm, and lasted 6 minutes Above, the diagnosis of left main stenosis sensitivity was 74%, the expected value of 32%.