CLINICAL CASE OF MYOCARDIAL INFARCTION AS A RESULT OF CORONARITIS AND ANEMIA

Authors

  • M. I. Shved I. Horbachevsky Ternopil State Medical University
  • N. М. Kovbasa I. Horbachevsky Ternopil State Medical University
  • O. L. Sydorenko I. Horbachevsky Ternopil State Medical University
  • O. L. Pavlyk I. Horbachevsky Ternopil State Medical University
  • N. A. Golovach I. Horbachevsky Ternopil State Medical University

DOI:

https://doi.org/10.11603/2415-8798.2019.1.9962

Keywords:

clinical case, acute coronary syndrome, coronaritis, differential diagnosis, treatment

Abstract

In clinical practice there are cases of acute coronary syndrome without coronary atherosclerosis. Another cause of acute coronary syndrome may be inflammation of the coronary arteries (coronaritis), which often occurs under the mask of more common diseases.

The aim of the study – to increase the doctors’ awareness about the algorithm of differential diagnosis with the purpose of adequate treatment of myocardial necrosis as a result of coronaritis in systemic vasculitis.

Materials and Methods. System analysis, biosensitism and analysis of the case of a particular patient with myocardial infarction against coronary and severe iron deficiency anemia. The source search was carried out using the scientific statistical database of medical information: PubMed-NCBI, CyberLeninka.

Results and Discussion. Bibliosemantics analysis of the clinical manifestations in patients with systemic vasculitis and our own clinical observations suggests the possibility of developing an immune inflammation of coronary arteries in these patients, which proceeds under the clinical mask of acute coronary syndrome. Lack of reciprocity of infarct-like electrocardiographic changes and preservation of S-wave in the leads with ST-elevation, when the onset of the disease manifests itself against the background of intoxication syndrome and inflammatory changes, with multiple (systemic) organ lesions of internal organs, allows us to suspect the non-trombotic genesis of coronary disorders. In this case only coronary angiography is the main differential diagnostic criterion.

Conclusions. The inflammatory genesis of myocardial injury/necrosis (coronaritis) should be suspected in case of the presence of infarction-like electrocardiographic changes in patients whose onset of the disease is manifested on the background of intoxication syndrome and inflammatory changes, and in case of multiple-organ failure of internal organs. Coronary angiography is the main differential diagnostic criterion in this case. Early diagnosis and adequate pathogenetic treatment of the coronaritis will help to achieve a fast clinical effect and prevent the development of life-threatening complications.

References

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Published

2019-04-10

How to Cite

Shved, M. I., Kovbasa N. М., Sydorenko, O. L., Pavlyk, O. L., & Golovach, N. A. (2019). CLINICAL CASE OF MYOCARDIAL INFARCTION AS A RESULT OF CORONARITIS AND ANEMIA. Bulletin of Scientific Research, (1), 145–150. https://doi.org/10.11603/2415-8798.2019.1.9962

Issue

No. 1 (2019)

Section

EXCHANGE OF EXPERIENCE

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