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Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Discordance between the Clinical Presentation and Morphology of Myocardial Infarction in a Patient with Acute
Truong Huy Hoang1, Pavel V Lazarev1, Victor V Maiskov1,2
1Department of Internal Diseases, Medical Institute, RUDN University, Moscow, Russia.
Insights
Type 1 myocardial infarction (T1MI) involves plaque disruption, while type 2 myocardial infarction (T2MI) stems from supply/demand mismatch. A case highlights T2MI triggers masking underlying T1MI, emphasizing the need for thorough diagnosis.
Area of Science:
- Cardiology
- Pathology
Background:
- Type 1 myocardial infarction (T1MI) is typically caused by atherosclerotic plaque disruption.
- Type 2 myocardial infarction (T2MI) arises from myocardial oxygen supply/demand imbalance due to various triggers like anemia or tachyarrhythmias.
- Angiography is often underutilized in T2MI cases, despite potential coexisting coronary artery disease.
Abstract:
While atherosclerotic plaque disruption remains the hallmark of type 1 myocardial infarction (T1MI), multiple other mechanisms provoking myocardial supply/demand mismatch (eg, anemia and tachyarrhythmias) are recognized as the potential causes of type 2 myocardial infarction (T2MI). In clinical practice, angiography is underutilized in patients with MI that have typical T2MI triggers, although the presence of these triggers and various forms of atherosclerotic coronary artery disease is not mutually exclusive. We describe a 70-year-old man that developed MI during hospitalization for gastrointestinal bleeding. He was treated conservatively without angiography due to posthemorrhagic anemia, which is a recognized T2MI trigger, and subsequently developed refractory cardiogenic shock. Autopsy revealed atherothrombosis, which is characteristic of T1MI.
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