Features of the course of myocardial infarction without coronary artery obstruction
- Authors: Maksimov N.I.1, Grishin I.S.1
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Affiliations:
- Izhevsk State Medical Academy
- Issue: Vol 38, No 4 (2021)
- Pages: 36-41
- Section: Original studies
- URL: https://journals.rcsi.science/PMJ/article/view/95712
- DOI: https://doi.org/10.17816/pmj38436-41
- ID: 95712
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Abstract
Objective. To study the clinical and laboratory features and the early post-infarction period in patients suffering from myocardial infarction with non-obstructive coronary arteries (MINOCA).
Materials and methods. A survey of 62 patients hospitalized to the Republican Clinical and Diagnostic Center of the Ministry of Health of the Republic of Udmurtia with a diagnosis of "myocardial infarction" was conducted, 30 of whom had a single-vessel lesion of the coronary bed, 32 – myocardial infarction without coronary artery obstruction.
Results. Differences in the clinical manifestations of the acute period were noted by the presence of syncope, isolated shortness of breath, and a difficult-to-explain feeling in the chest. The time from the onset of symptoms to hospitalization in the MINOCA group exceeds 1.7 hours. The MINOCA group had a much higher level of markers of myocardial necrosis (troponin I level of 8.9 ng/ml compared to 1.75 ng/ml), despite a significantly lower frequency of detection of hypokinesia zones and the number of affected segments.
Conclusions. It is necessary to improve public awareness of the symptoms of acute coronary syndrome, including its atypical manifestations. Routine PCI does not "save" from subsequent angina pectoris if it is present before MI.
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##article.viewOnOriginalSite##About the authors
N. I. Maksimov
Izhevsk State Medical Academy
Email: vanya.grishin.91@bk.ru
MD, PhD, Professor, Head of Department of Hospital Therapy with Couse of Cardiology and Functional Diagnostics
Russian Federation, IzhevskI. S. Grishin
Izhevsk State Medical Academy
Author for correspondence.
Email: vanya.grishin.91@bk.ru
postgraduate student, Department of Hospital Therapy with Couse of Cardiology and Functional Diagnostics
Russian Federation, IzhevskReferences
- Kruchinova S.V., Kosmacheva E.D., Raff S.A., Porkhanov V.A. Data analysis of patients with myocardial infarction without obstructive coronary artery disease when comparing the total register of acute coronary syndrome in the Krasnodar region with foreign registries. Sibirskiy meditsinskiy zhurnal 2018; 33 (4): 38–43 (in Russian).
- Agewall S., Beltrame J.F., Reynolds H.R., Niessner A., Rosano G., Caforio A.L., De Caterina R., Zimarino M., Roffi M., Kjeldsen K., Atar D., Kaski J.C., Sechtem U., Tornvall P. On behalf of the WG on Cardiovascular Pharmacotherapy. ESC working group position paper on myocardial infarction with non-obstructive coronary arteries. Eur Heart J 2017; 38 (3): 143–153.
- Galyavich A.S. On the new classification of coronary heart disease. Ros-siyskiy kardiologicheskiy zhurnal 2020; 25 (2): 3727 (in Russian).
- Shilova A.S., Sherashov A.V., Pershina E.S. i dr. Myocardial infarction without obstructive atherosclerosis of the coronary arteries: current state of the problem and approaches to diagnosis. Klinitsist 2018; 12 (3–4): 10–14 (in Russian).
- Niccoli G., Scalone G., Crea F. Acute myocardial infarction with no obstructive coronary atherosclerosis: mechanisms and management. Eur Heart J 2015; 36 (8): 475–481.
- Averkov O.V., Barbarash O.L., Boytsov S.A. i dr. Differentiated approach in diagnosis, formulation of the diagnosis, case management and statistical accounting of myocardial infarction type 2 (agreed position). Rossiyskiy kardiologicheskiy zhurnal 2019; (6): 7–21 (in Russian).