关键词: 心绞痛, 变异型, 冠状血管造影术, 鼻炎, 过敏反应, 过敏性鼻炎, 综述

Abstract: Variant angina is not uncommon，but variant angina without coronary artery occlusion is rare.Following the publication of the management guidelines by the European Society Cardiology in 2018，the American Heart Association announced the recommendations for the diagnosis and management of patients with myocardial infarction in the absence of obstructive coronary artery disease in 2019，which reflect that these diseases have attracted more and more attention.Most of the symptoms of patients with variant angina without coronary artery occlusion can be controlled after adding diltiazem and nicorandil，but the treatment for some patients is still very difficult due to unclear cause and pathogenesis of the disease.We reported the diagnostic and therapeutic procedure of a case of severe variant angina with allergic rhinitis without coronary stenosis and slow coronary flow，who was ever diagnosed with cardiac neurosis.Moreover，a literature review was made.The points for attention derived from this study are： Do not make a diagnosis hastily when there is no stenosis in coronary angiography，especially the patient is found to be with right coronal lesion（which is prone to spasm），it is essential to continue to identify clues for a definite diagnosis.And when exploring the causes of coronary artery spasm，allergic constitution and hormone application should be considered.

Key words: Angina pectoris, variant；Coronary angiography；Rhinitis；Anaphylaxis；Allergic rhinitis；Review