THE DEVELOPMENT OF EXTENSIVE MYOCARDIAL INFARCTION DUE TO MULTIPLE CORONARY ARTERY ANEURYSMS
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i1.11086Keywords:
coronary artery aneurysm, diagnostic-therapeutic algorithmAbstract
A wide range of fluctuations in the prevalence of aneurysmal coronary artery disease (from 0.02 to 1.4 %) is associated not only with the rarity of the pathology, but also with the non-specificity of clinical manifestations and the difficulties of visualization diagnostics .
The aim – analysis of modern approaches to diagnosis and treatment of patients with multiple coronary artery aneurysms complicated by acute myocardial infarction and analysis of our own clinical case to assess the adequacy of the proposed clinical diagnostic and treatment algorithm .
Material and Methods. Systemic analysis, bibliosemantics and case analysis of multiple coronary vessel aneurysms were used.
Results and Discussion. This clinical case is characterized by the typical clinical symptoms of acute coronary syndrome (ACS), which were caused by multiple coronary artery aneurysms. The etiology of ACS was identified using the method of contrasting coronary angiography. According to the proposed diagnostic and therapeutic algorithm for the management of such patients, the patient underwent coronary artery bypass grafting and prescribed dual antiplatelet and statin therapy, which gave a stable clinical effect.
Conclusions. The variety of clinical manifestations of aneurysmal heart disease determines the significant diagnostic difficulties of the disease and justifies the need to use of various diagnostic imaging approaches (coronary angiography, computerized tomography, aortography), and the direct tactics of treating patients with aneurysms/ectasia of the coronary arteries should be individualized on the basis of the proposed diagnostic and therapeutic algorithm.
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