| Popis: |
The official abbreviation MINOCA (myocardial infarction with nonobstructive coronary arteries) appeared for the first time in the clinical guidelines of the European Society of Cardiology (ESC, 2017), which is clinically determined by the presence of universal criteria for acute myocardial infarction (MI) ≥50%. Under the “mask” of this diagnosis hides not only MI as a manifestation of ischemia, but also diseases with other mechanisms of myocardial damage. ESC experts consider MINOCA as a working diagnosis (similar to the diagnosis of heart failure or anemia, which requires further action to clarify), or rather – a syndrome that dictates to the doctor after coronary angiography the need for additional examination and differential diagnosis to identify the cause which leading to this condition. It is noted that MI in MINOCA can be both type 1 (due to myocardial ischemia in the blood supply of the spacecraft with vulnerable atherosclerotic plaque) and type 2 (develops as a result of vasospasm, severe anemia, coronary embolism, arrhythmia etc). MINOCA patients are younger, more often women, and tend to have less cardiovascular risk factors. Two-thirds of MINOCA subjects have ST segment elevation In the article, the authors focus on the causes, recommended diagnostic methods, modern diagnostic algorithms, prognosis and treatment of MI without coronary artery obstruction (MINOCA). |
