Nederlands tijdschrift voor geneeskunde · 2019
[Chest pain after angiography without anomalies].
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Schutte Tim, Ramawadhdoebe Shanti, Schotten Jeroen
Аннотация
BACKGROUND: Myocardial infarction can be categorized based on ECG-findings (presence or absence of ST-elevations on STEMI/NSTEMI) or on the results from coronary angiography (CAG) (presence or absence of obstructive atherosclerosis). Myocardial infarction without significant obstruction on CAG (Myocardial Infarction with Non-Obstructive Coronary Arteries/Atherosclerosis; MINOCA) occurs in up to a quarter of patients with myocardial infarcts. These patients have a higher risk of future heart diseases; up to a quarter of MINOCA patients suffer from heart diseases during a median follow-up of four years.
CASE DESCRIPTION: We describe a 55-year old woman, who suffered from two myocardial infarctions in one week. The first time, no ST-elevation was detected with ECG and CAG was without abnormalities (MINOCA). Five days later, she experienced the same symptoms; ECG showed ST-elevations and CAG revealed a coronary dissection.
CONCLUSION: Patients with a myocardial infarction without coronary obstruction (MINOCA) have a higher risk of future heart diseases. In this case, a coronary dissection.
CASE DESCRIPTION: We describe a 55-year old woman, who suffered from two myocardial infarctions in one week. The first time, no ST-elevation was detected with ECG and CAG was without abnormalities (MINOCA). Five days later, she experienced the same symptoms; ECG showed ST-elevations and CAG revealed a coronary dissection.
CONCLUSION: Patients with a myocardial infarction without coronary obstruction (MINOCA) have a higher risk of future heart diseases. In this case, a coronary dissection.