Characteristics of clinical signs, laboratory and instrumental examinations in various mechanisms of development of type 2 myocardial infarction

Aim. To identify different pathogenetic variants of myocardial infarction type 2 (MI-2). Material and methods. Reviewed 4168 cases of MI admitted in multidisciplinary hospital for 10 years. 353 patients met the criteria for MI-2 without signs of coronary atherothrombosis (CA). In the study group,...

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Autores principales:	Dmitrii V. Oblavatckii, Svetlana A. Boldueva
Formato:	article
Lenguaje:	EN RU
Publicado:	Concilium Medicum 2021
Materias:	type 2 myocardial infarction vasospastic infarction embologenous infarction Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/4067fa4f844e481fa37a19d893d08f57
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spelling	oai:doaj.org-article:4067fa4f844e481fa37a19d893d08f572021-12-01T22:07:01ZCharacteristics of clinical signs, laboratory and instrumental examinations in various mechanisms of development of type 2 myocardial infarction2221-71852658-570710.17816/22217185.2021.3.201042https://doaj.org/article/4067fa4f844e481fa37a19d893d08f572021-10-01T00:00:00Zhttps://cardiosomatics.orscience.ru/2221-7185/article/viewFile/83282/63771https://doaj.org/toc/2221-7185https://doaj.org/toc/2658-5707Aim. To identify different pathogenetic variants of myocardial infarction type 2 (MI-2). Material and methods. Reviewed 4168 cases of MI admitted in multidisciplinary hospital for 10 years. 353 patients met the criteria for MI-2 without signs of coronary atherothrombosis (CA). In the study group, the features of clinical and laboratory-instrumental manifestations were evaluated. Results. Cases of IM-2 were subdivided into 4 clinical-pathogenic variants (CPV): 1-CPV developed due an increasing in myocardial oxygen demand; 2-CPV, arising from a decrease in the supply of oxygen; 3-CPV associated with local coronary circulation disorder; 4-CPV developed due to the combined oxygen-energy imbalance. In 72 (20.4%) cases, 1-CPV was detected, caused by a hypertensive crisis and/or tachyarrhythmias; 2-CPV observed in 73 (20.68%) patients with hypotension, anemia, microvascular dysfunction, respiratory failure; 3-CPV caused by spasm and embolism of CA was detected in 47 (13.31%) cases; in 161 (45.61%) patients, IM-2 is associated with increased myocardial oxygen demand with reduced oxygen delivery. The gender and risk factors in groups are comparable. The average age of 1-CPV- and 3-CPV-patients was less and amounted to 65.7 and 56.5 versus 70.2 and 73.8 years in the 2-CPV and 4-CPV. Typical clinical and laboratory-instrumental signs of MI were common for patients with 1-CPV and 3-CPV, while 2-CPV and 4-CPV more often had chronic severe pathology, multivessel coronary disorder, and the clinical presentation and ischemic signs were less common. Conclusion. Clinical manifestations and results of examination of patients with MI-2 depend on the mechanism of its development.Dmitrii V. OblavatckiiSvetlana A. BolduevaConcilium Medicumarticletype 2 myocardial infarctionvasospastic infarctionembologenous infarctionDiseases of the circulatory (Cardiovascular) systemRC666-701Diseases of the endocrine glands. Clinical endocrinologyRC648-665ENRUКардиоСоматика, Vol 12, Iss 3, Pp 132-138 (2021)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	type 2 myocardial infarction vasospastic infarction embologenous infarction Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	type 2 myocardial infarction vasospastic infarction embologenous infarction Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the endocrine glands. Clinical endocrinology RC648-665 Dmitrii V. Oblavatckii Svetlana A. Boldueva Characteristics of clinical signs, laboratory and instrumental examinations in various mechanisms of development of type 2 myocardial infarction
description	Aim. To identify different pathogenetic variants of myocardial infarction type 2 (MI-2). Material and methods. Reviewed 4168 cases of MI admitted in multidisciplinary hospital for 10 years. 353 patients met the criteria for MI-2 without signs of coronary atherothrombosis (CA). In the study group, the features of clinical and laboratory-instrumental manifestations were evaluated. Results. Cases of IM-2 were subdivided into 4 clinical-pathogenic variants (CPV): 1-CPV developed due an increasing in myocardial oxygen demand; 2-CPV, arising from a decrease in the supply of oxygen; 3-CPV associated with local coronary circulation disorder; 4-CPV developed due to the combined oxygen-energy imbalance. In 72 (20.4%) cases, 1-CPV was detected, caused by a hypertensive crisis and/or tachyarrhythmias; 2-CPV observed in 73 (20.68%) patients with hypotension, anemia, microvascular dysfunction, respiratory failure; 3-CPV caused by spasm and embolism of CA was detected in 47 (13.31%) cases; in 161 (45.61%) patients, IM-2 is associated with increased myocardial oxygen demand with reduced oxygen delivery. The gender and risk factors in groups are comparable. The average age of 1-CPV- and 3-CPV-patients was less and amounted to 65.7 and 56.5 versus 70.2 and 73.8 years in the 2-CPV and 4-CPV. Typical clinical and laboratory-instrumental signs of MI were common for patients with 1-CPV and 3-CPV, while 2-CPV and 4-CPV more often had chronic severe pathology, multivessel coronary disorder, and the clinical presentation and ischemic signs were less common. Conclusion. Clinical manifestations and results of examination of patients with MI-2 depend on the mechanism of its development.
format	article
author	Dmitrii V. Oblavatckii Svetlana A. Boldueva
author_facet	Dmitrii V. Oblavatckii Svetlana A. Boldueva
author_sort	Dmitrii V. Oblavatckii
title	Characteristics of clinical signs, laboratory and instrumental examinations in various mechanisms of development of type 2 myocardial infarction
title_short	Characteristics of clinical signs, laboratory and instrumental examinations in various mechanisms of development of type 2 myocardial infarction
title_full	Characteristics of clinical signs, laboratory and instrumental examinations in various mechanisms of development of type 2 myocardial infarction
title_fullStr	Characteristics of clinical signs, laboratory and instrumental examinations in various mechanisms of development of type 2 myocardial infarction
title_full_unstemmed	Characteristics of clinical signs, laboratory and instrumental examinations in various mechanisms of development of type 2 myocardial infarction
title_sort	characteristics of clinical signs, laboratory and instrumental examinations in various mechanisms of development of type 2 myocardial infarction
publisher	Concilium Medicum
publishDate	2021
url	https://doaj.org/article/4067fa4f844e481fa37a19d893d08f57
work_keys_str_mv	AT dmitriivoblavatckii characteristicsofclinicalsignslaboratoryandinstrumentalexaminationsinvariousmechanismsofdevelopmentoftype2myocardialinfarction AT svetlanaaboldueva characteristicsofclinicalsignslaboratoryandinstrumentalexaminationsinvariousmechanismsofdevelopmentoftype2myocardialinfarction
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Characteristics of clinical signs, laboratory and instrumental examinations in various mechanisms of development of type 2 myocardial infarction

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