循環器ジャーナル65巻4号

2017年10月発行

特集 ACSの診断と治療はどこまで進歩したのか Ⅲ．ACSの治療

特殊な病態　冠動脈解離と冠攣縮

著者： 伊藤智範¹²

所属機関： ¹岩手医科大学内科学講座循環器内科分野 ²岩手医科大学医学教育学講座地域医療学分野

ページ範囲：P.643 - P.651

Point
・冠動脈解離は，冠動脈造影では診断が容易でない例があり，攣縮と安易に診断せず，積極的な冠動脈内イメージングが必要である．
・冠攣縮は，急性冠症候群の原因か結果かを確定しきれない例も少なくない．特に，プラーク破綻の原因の一つが冠攣縮で起こる可能性が指摘されているものの，それを証明した研究はない．
・Kounis症候群には，多彩な原因があり，医療面接での十分なアレルギー歴の聴取と，医原的・複合的な要因をも勘案することが必要である．

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