冠攣縮性狭心症の評価  [in Japanese] Evaluation of Coronary Spastic Angina  [in Japanese]

Author(s)

Abstract

冠攣縮(れんしゅく)性狭心症の告知および診断書を目にする機会は少なくないが,生命保険の査定者にとって冠攣縮という現象および冠攣縮性狭心症は理解が難しいものと考える。冠攣縮は日本人に多く,異型狭心症のみならず他の狭心症や急性心筋梗塞等虚血性心疾患全般にも重要な役割を果たしている。本稿では近年発行された日本循環器学会の「冠攣縮性狭心症の診断と治療に関するガイドライン」を概説するとともに,最近の知見および同学会の他ガイドラインからの関連記載も多く取り入れ,保険医学の観点から冠攣縮性狭心症を考察した。一般に冠攣縮性狭心症の予後は労作性狭心症と比較し良好とされており,特に日本人では心筋梗塞の発症が少ないことが低い死亡率の原因と考えられているが,不整脈による突然死の経過を取りうる例が少なくない。また難治性冠攣縮性狭心症という一群が存在する,点及び致死的不整脈,失神を合併した例の経過に留意したい。

We often assess coronary spastic angina in underwriting and claim assessment of life insurance. However, it seems that many underwriters and claim assessors have difficulties in understanding coronary spasm and coronary spastic angina. The prevalence of coronary spasm is high in Japanese and coronary spasm plays an important role in the pathogenesis of not only variant angina but also a wide variety of ischemic heart disease including other forms of angina pectoris and acute myocardial infarction. The objective of this paper is to outline the Guidelines for Diagnosis and Treatment of Patients with Coronary spastic Angina (JCS2008) issued in recent years and to review recent articles and other related Guidelines of Japanese Circulation Society in view of insurance medicine. In general, the prognosis of Coronary spastic angina is better compared to effort angina and infrequent incidence of acute myocardial infarction can explain the low mortality rate of coronary spastic angina. Some patients experience cardiac sudden death due to lethal arrhythmia caused by coronary spasm. We must pay attention to subgroup of refractory coronary spastic angina and the clinical course of patients with lethal arrhythmia and syncope.

Journal

  • The journal of the Association of Life Insurance Medicine of Japan

    The journal of the Association of Life Insurance Medicine of Japan 110(1), 12-21, 2012-03-17

    The Association of Insuramce Medicine of Japan

References:  21

Codes

  • NII Article ID (NAID)
    110009426020
  • NII NACSIS-CAT ID (NCID)
    AN00197853
  • Text Lang
    JPN
  • Article Type
    REV
  • ISSN
    0301262X
  • NDL Article ID
    023625635
  • NDL Call No.
    Z19-675
  • Data Source
    CJP  NDL  NII-ELS 
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