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Medicinski glasnik Instituta za štitastu žlezdu i metabolizam "Zlatibor"
2005, vol. 10, br. 14, str. 53-61
jezik rada: srpski
vrsta rada: članak
objavljeno: 02/06/2007
Miokardni mostovi - morfološke karakteristike, klinički značaj, dijagnoza i lečenje
Klinički centar Srbije, Klinika za kardiologiju, Beograd

Sažetak

Miokardni most definišemo kao snop mišićnih vlakana koje prelaze preko koronarne arterije. On predstavlja kliničko stanje sa više mogućih manifestacija, a njegov klinički značaj je i dalje predmet rasprava. Ovaj rad daje prikaz aktuelnih saznanja o morfologiji, kliničkom značaju i eventualnom lečenju osoba sa miokardnim mostom. U toku svake sistole premoštena arterija biva komprimovana. Miokardni mostovi su povezani sa anginom pektoris, aritmijom, smanjenom ninkcijom leve komore, zastojem srca kao i iznenadnom srčanom smrti. Podaci ukazuju da je intima arterije ispod mosta zaštićena od ateroskleroze, dok je proksimalni segment osetljiviji na razvoj aterosklerotičnih lezija zbog hemodinamskih poremećaja. Nove tehnike (npr.intravaskularna ultrasonografija i intrakoronarni Doppler) su otkrile nove osobine i patofiziološke procese kao što su recimo izmene dijastolnog protoka. Terapija uglavnom uključuje b-blokatore. Trebalo bi izbegavati nitrate zato što se simptomi mogu pogoršati. Kod odabranih pacijenata se pokušalo sa postavljanjem stenta i hirurškim pristupom. Potrebna su dodatna istaživanja da bi se definisali pacijenti kod kojih je miokardni most potencijalno patološki, dok su randomizirane multicentrične dugoročne studije potrebne da prouče prirodu bolesti, stratifikuju pacijente prema ugroženosti i utvrde optimalni terapijski pristup.

Ključne reči

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