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Vojnosanitetski pregled
2014, vol. 71, br. 11, str. 1066-1071
jezik rada: engleski
vrsta rada: prikaz slučaja
doi:10.2298/VSP1411066P


Sinkopa kao početni simptom ostijalne lezije glavnog stabla leve koronarne arterije sa kardiogenim šokom
aClinic for Cardiology, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Novi Sad + Faculty of Medicine, Novi Sad
bFaculty of Medicine, Novi Sad + Clinic for Cardiovascular Surgery, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Novi Sad

e-adresa: petrovici@hotmail.com nsbim@eunet.rs

Sažetak

Uvod. Sinkopa predstavlja relativno netipičan simptom akutnog koronarnog sindroma. Sama sinkopa ne pruža dovoljno informacija za dijagnozu akutnog koronarnog događaja, naročito lezije glavnog stabla leve koronarne arterije, bez malignih poremećaja ritma i provođenja. Prikaz bolesnika. Bolesnik, star 63 godine, primljen je u jedinicu intenzivne kardiološke nege zbog kratkotrajnog gubitka svesti, u sinus tahikardiji, sa znacima akutne srčane slabosti, hipotenzivan. Elektrokardiogram je pokazivao suspektne znake za razvoj akutnog infarkta miokarda prednjeg zida. Zbog toga, kao i zbog razvoja početnog kardiogenog šoka, indikovana je i urađena urgentna koronarografija (subokluzivna lezija ostijuma glavnog stabla leve koronarne arterije) i primarna perkutana koronarna intervencija sa implantiranom intraaortnom balon pumpom. Direktno je ugrađen stent obložen lekom sa optimalnim primarnim rezultatom. Zaključak. Brza dijagnoza, naročito sa ovakvom relativno atipičnom kliničkom slikom, brza primena reperfuzione terapije u vidu primarne perkutane koronarne intervencije u akutnom infarktu miokarda komplikovanim kardiogenim šokom, doprinosi poboljšanju preživljavanja i kvalitetu života bolesnika. Ovaj prikaz bolesnika klinički je poučan zbog relativno atipične prezentacije i izvršenih intervencija.

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