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2019, vol. 25, br. 3, str. 165-172
Myocardial infarction with no coronary artery obstruction (MINOCA): Mystery solved
Gradski zavod za hitnu medicinsku pomoć, Beograd

e-adresasmchitna94@gmail.com
Ključne reči: infarkt miokarda; MINOCA; patofiziologija; terapija
Sažetak
Infarkt miokarda bez opstrukcije koronarnih arterija (MINOCA) je heterogeni klinički entitet koji se karakteriše kliničkim znacima akutnog infarkta miokarda (AMI), odsustvom opstruktivne bolesti koronarnih arterija (≥50% stenoza) i očiglednog uzroka za akutnu prezentaciju u vreme angiografije. Prevalenca MINOCA-e se kreće od 1% do 14% kod pacijenata sa dijagnozom AMI. Češći je kod žena kao i kod pacijenata koji se prezentuju kao infarkt miokarda bez elevacije ST-segmenta (NSTEMI). Iako zavisi od uzroka, prognoza MINOCA je ozbiljna, sa jednogodišnjim mortalitetom od oko 3,5%. Različiti patofiziološki mehanizmi, odgovorni za MINOCA uključuju disrupciju plaka, spazam koronarnih arterija, spontanu koronarnu disekciju, koronarnu trombozu/emboliju i koronarnu mikrovaskularnu disfunkciju. Utvrđivanje osnovnih uzroka MINOCA treba da usmeri lekara ka izboru optimalnog lečenja.
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