CardioSomaticsCardioSomatics2221-71852658-5707Eco-Vector8328210.17816/22217185.2021.3.201042Research ArticleCharacteristics of clinical signs, laboratory and instrumental examinations in various mechanisms of development of type 2 myocardial infarctionOblavatckiiDmitrii V.<p>Graduate Student</p>dimi1987@yandex.ruhttps://orcid.org/0000-0003-1628-0193BolduevaSvetlana A.<p>D. Sci. (Med.), Prof., Mechnikov North-Western State Medical University</p>dimi1987@yandex.ruhttps://orcid.org/0000-0002-1898-084XMechnikov North-Western State Medical University281020211231321381710202117102021Copyright © 2021, Eco-Vector2021<p><strong><em>Aim.</em></strong> To identify different pathogenetic variants of myocardial infarction type 2 (MI-2).</p>
<p><strong><em>Material and methods.</em></strong> Reviewed 4168 cases of MI admitted in multidisciplinary hospital for 10 years. 353 patients met the criteria for MI-2 without signs of coronary atherothrombosis (CA). In the study group, the features of clinical and laboratory-instrumental manifestations were evaluated.</p>
<p><strong><em>Results. </em></strong>Cases of IM-2 were subdivided into 4 clinical-pathogenic variants (CPV): 1-CPV developed due an increasing in myocardial oxygen demand; 2-CPV, arising from a decrease in the supply of oxygen; 3-CPV associated with local coronary circulation disorder; 4-CPV developed due to the combined oxygen-energy imbalance. In 72 (20.4%) cases, 1-CPV was detected, caused by a hypertensive crisis and/or tachyarrhythmias; 2-CPV observed in 73 (20.68%) patients with hypotension, anemia, microvascular dysfunction, respiratory failure; 3-CPV caused by spasm and embolism of CA was detected in 47 (13.31%) cases; in 161 (45.61%) patients, IM-2 is associated with increased myocardial oxygen demand with reduced oxygen delivery. The gender and risk factors in groups are comparable. The average age of 1-CPV- and 3-CPV-patients was less and amounted to 65.7 and 56.5 versus 70.2 and 73.8 years in the 2-CPV and 4-CPV. Typical clinical and laboratory-instrumental signs of MI were common for patients with 1-CPV and 3-CPV, while 2-CPV and 4-CPV more often had chronic severe pathology, multivessel coronary disorder, and the clinical presentation and ischemic signs were less common.</p>
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