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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
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Extreme ST-segment elevations in seemingly no significant angiographic coronary artery abnormalities: a case report.
M Piels1,2, T Faes3, J Vainer3
1Maastricht University Medical Center (MUMC+), P. Debyelaan 25, 6229HX, Maastricht, The Netherlands. marc.piels@mumc.nl.
BMC Cardiovascular Disorders
|January 31, 2019
Summary
Myocardial infarction without obstructive coronary atherosclerosis (MINOCA) can lead to severe short-term adverse events, including death. This case highlights the critical need for further investigation into MINOCA
Area of Science:
- Cardiology
- Internal Medicine
- Pathophysiology
Background:
- Obstructive coronary artery disease is prevalent in ST-elevation myocardial infarction (STEMI) and non-STEMI.
- Myocardial infarction without obstructive coronary atherosclerosis (MINOCA) presents a diagnostic challenge.
- MINOCA is linked to long-term adverse events, but short-term risks are less understood.
Observation:
- A 49-year-old male presented with acute chest pain and ST-elevation myocardial infarction.
- Coronary angiography revealed no obstructive coronary artery disease.
- The patient experienced recurrent ischemia, ventricular fibrillation, and ultimately died, with post-mortem findings indicating massive myocardial infarction likely due to temporary left main coronary artery occlusion.
Findings:
- This case demonstrates that MINOCA can be associated with severe short-term adverse events.
- Vasospasm is a potential underlying mechanism for MINOCA.
- MINOCA is associated with increased mortality and ventricular arrhythmias.
Implications:
- When ST-elevations are present without significant coronary abnormalities, further diagnostic testing for MINOCA is crucial.
- Understanding the underlying mechanisms of MINOCA is vital for timely and effective patient management.
- Early identification and management of MINOCA can potentially improve patient outcomes and reduce mortality.
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