Andrey писал(а):Пациентка, 42 года. Считает себя больной с 2006г., когда впервые в жизни появились жгучие боли в грудной клетке, слабость (была в гостях у сестры в другом городе). При госпитализации в стационаре выявлен острый передний инфаркт миокарда. Наследственности по ИБС нет, АГ не страдает, липидограмма в норме. По КАГ - умеренный мышечный мостик в ПМЖВ. Вопрос - является ли данное частичное интрамуральное залегание ПМЖВ причиной такого выраженного трансмурального поражения? Или еще это что-то?
Андрей! А ЭКГ можно посмотреть. И "полный" анамнез хотелось бы? Особенно по болевому синдрому и сопутствующей патологии.
Causes of Myocardial Infarction without Coronary Atherosclerosis
Coronary Artery Disease Other than Atherosclerosis
Arteritis Luetic
Granulomatous (Takayasu disease)
Polyarteritis nodosa
Mucocutaneous lymph node (Kawasaki) syndrome
Disseminated lupus erythematosus
Rheumatoid spondylitis
Ankylosing spondylitis
Trauma to coronary arteries
Laceration
Thrombosis
Iatrogenic
Radiation (radiation therapy for neoplasia)
Coronary mural thickening with metabolic disease or intimal proliferative disease
Mucopolysaccharidoses (Hurler disease)
Homocystinuria
Fabry disease
Amyloidosis
Juvenile intimal sclerosis (idiopathic arterial calcification of infancy)
Intimal hyperplasia associated with contraceptive steroids or with the postpartum period
Pseudoxanthoma elasticum
Coronary fibrosis caused by radiation therapy
Luminal narrowing by other mechanisms
Spasm of coronary arteries (Prinzmetal angina with normal coronary arteries)
Spasm after nitroglycerin withdrawal
Dissection of the aorta
Dissection of the coronary artery
Emboli to Coronary Arteries
Infective endocarditis
Nonbacterial thrombotic endocarditis
Prolapse of mitral valve
Mural thrombus from left atrium, left ventricle, or pulmonary veins
Prosthetic valve emboli
Cardiac myxoma
Associated with cardiopulmonary bypass surgery and coronary arteriography
Paradoxical emboli
Papillary fibroelastoma of the aortic valve (“fixed embolus”)
Thrombi from intracardiac catheters or guidewires
Congenital Coronary Artery Anomalies
Anomalous origin of left coronary from pulmonary artery
Left coronary artery from anterior sinus of Valsalva
Coronary arteriovenous and arteriocameral fistulas
Coronary artery aneurysms
Myocardial Oxygen Demand-Supply Disproportion
Aortic stenosis, all forms
Incomplete differentiation of the aortic valve
Aortic insufficiency
Carbon monoxide poisoning
Thyrotoxicosis
Prolonged hypotension
Takotsubo cardiomyopathy
Hematological (in situ Thrombosis)
Polycythemia vera
Thrombocytosis
Disseminated intravascular coagulation
Hypercoagulability, thrombosis, thrombocytopenic purpura
Miscellaneous
Cocaine abuse
Myocardial contusion
Myocardial infarction with normal coronary arteries
Complication of cardiac catheterization
Modified from Cheitlin MD, McAllister HA, de Castro CM: Myocardial infarction without atherosclerosis. JAMA 231:951, 1975. Copyright 1975, American Medical Association.