冠状动脉粥样硬化性心脏病(简称冠心病)的基本问题是粥样硬化病变使冠状动脉管腔狭窄导致的心肌缺血。然而有时心肌缺血与冠状动脉病变程度不呈平行关系,见于冠状动脉管腔较通畅的患者,提示心肌缺血可由于血管痉挛引起。血管痉挛最常发生于冠状动脉有粥样斑块的部位。血管痉挛对冠心病临床表现、病程和预后的影响是不容忽视的。现拟谈以下几点:一、对冠状动脉痉挛的认识过程早在十九世纪Latham 和Osler 已提到心绞痛可能与冠状动脉痉挛有关。到二十世纪五十年代中期,当时病理生理实验大多在麻醉开胸 Coronary atherosclerotic heart disease (referred to as coronary heart disease) is the basic problem of atherosclerosis coronary artery stenosis caused by myocardial ischemia. However, sometimes myocardial ischemia and coronary artery lesions did not show a parallel relationship, found in patients with coronary artery lumen smoother, suggesting that myocardial ischemia may be caused by vasospasm. Vasospasm occurs most often in coronary atherosclerotic plaque sites. Vasospasm of coronary heart disease clinical manifestations, duration and prognosis can not be ignored. Now intends to talk about the following points: First, the understanding of coronary artery spasm As early as the 19th century, Latham and Osler have mentioned that angina pectoris may be related to coronary artery spasm. By the mid-1950s, most of the pathophysiological experiments were undergoing thoracotomy