Infarto agudo de miocardio sin enfermedad coronaria ateroesclerótica obstructiva: utilidad de las imágenes intravasculares y resonancia cardíaca en su diagnóstico
| Autor: | Rodrigo Monsalve, Jorge Sandoval B., Pedro Llerena, Pabla Cataldo V., Polentzi Uriarte, Fernando Pineda, Soledad GonzÁlez, Christian Garrido G., Marco Coello V., Mario Araya H., Pablo Antileo, Gonzalo Pereira, Alfonso Garcia, Tomas Delgado A., Christian Dauvergne, Manuel Méndez, Yalile Nauhm, Fernando J. Verdugo, Cristobal Ramos |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
education.field_of_study Myocarditis medicine.diagnostic_test business.industry Population Myocardial Infarction Cardiomyopathy Magnetic resonance imaging General Medicine Coronary Angiography medicine.disease Magnetic Resonance Imaging Coronary artery disease Internal medicine medicine Cardiology Myocardial infarction Thrombus Risk factor business education Tomography Optical Coherence Ultrasonography Interventional |
| Zdroj: | Revista médica de Chile v.148 n.8 2020 SciELO Chile CONICYT Chile instacron:CONICYT |
| ISSN: | 0034-9887 |
| Popis: | Background: Myocardial infarction with non-obstructive coronary artery disease (MINOCA) is common. Cardiac magnetic resonance (CMR) and intravascular imaging (IVI) may be useful for establishing its etiology. Aim: To describe a population with MINOCA and its multi-image assessment using IVI or CMR. Material and Methods: Review of medical records, imaging and functional studies of patients with MINOCA treated in three different clinical centers between 2015 and 2019. Results: Twenty-eight patients with MINOCA and IVI were included. Seventy eight percent were women, 46% had hypertension, 32% smoked and 32% had dyslipidemia. At wall motion assessment, 46% presented apical ballooning pattern. In 36% of patients IVI identified lesions that explained the cause of MINOCA, namely plaque disruption (PD) in 18%, spontaneous coronary dissection in 11% and a thrombus without PD in 7%. Forty-six percent of patients had uncomplicated atherosclerotic plaques, and 36% had no pathological findings. CMR was performed in 50% of patients, identifying in all a diagnostic pattern. In nine cases it was compatible with stress cardiomyopathy, three cases had a myocarditis and two cases had transmural infarctions. PD and transmural late gadolinium enhancement were observed in 23% of patients with apical ballooning. Patients with a pattern of myocarditis did not have acute pathological findings at IVI. After a mean follow-up of 16.4±11.4 months, 3 patients with PD died. Conclusions: Among patients with MINOCA, there was a predominance of female gender with low cardiovascular risk factor load. The multi-image assessment allowed greater precision for etiological diagnosis of MINOCA. Apical ballooning was not pathognomonic for stress cardiomyopathy. PD was associated with mortality. |
| Databáze: | OpenAIRE |
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