Infarto agudo de miocardio sin enfermedad coronaria ateroesclerótica obstructiva: utilidad de las imágenes intravasculares y resonancia cardíaca en su diagnóstico
Rev. méd. Chile
; 148(8)ago. 2020.
Artículo
en Español
|
LILACS-Express
| LILACS
| ID: biblio-1389306
Biblioteca responsable:
CL1.1
ABSTRACT
Background:
Myocardial infarction with non-obstructive coronary artery disease (MINOCA) is common. Cardiac magnetic resonance (CMR) and intravascular imaging (IVI) may be useful for establishing its etiology.Aim:
To describe a population with MINOCA and its multi-image assessment using IVI or CMR. Material andMethods:
Review of medical records, imaging and functional studies of patients with MINOCA treated in three different clinical centers between 2015 and 2019.Results:
Twenty-eight patients with MINOCA and IVI were included. Seventy eight percent were women, 46% had hypertension, 32% smoked and 32% had dyslipidemia. At wall motion assessment, 46% presented apical ballooning pattern. In 36% of patients IVI identified lesions that explained the cause of MINOCA, namely plaque disruption (PD) in 18%, spontaneous coronary dissection in 11% and a thrombus without PD in 7%. Forty-six percent of patients had uncomplicated atherosclerotic plaques, and 36% had no pathological findings. CMR was performed in 50% of patients, identifying in all a diagnostic pattern. In nine cases it was compatible with stress cardiomyopathy, three cases had a myocarditis and two cases had transmural infarctions. PD and transmural late gadolinium enhancement were observed in 23% of patients with apical ballooning. Patients with a pattern of myocarditis did not have acute pathological findings at IVI. After a mean follow-up of 16.4±11.4 months, 3 patients with PD died.Conclusions:
Among patients with MINOCA, there was a predominance of female gender with low cardiovascular risk factor load. The multi-image assessment allowed greater precision for etiological diagnosis of MINOCA. Apical ballooning was not pathognomonic for stress cardiomyopathy. PD was associated with mortality.
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
LILACS
Tipo de estudio:
Estudio diagnóstico
/
Estudio pronóstico
/
Factores de riesgo
Aspecto:
Preferencia del paciente
Idioma:
Español
Revista:
Rev. méd. Chile
Asunto de la revista:
Medicina
Año:
2020
Tipo del documento:
Artículo