Features of the course of myocardial infarction without coronary artery obstruction

Abstract

Objective. To study the clinical and laboratory features and the early post-infarction period in patients suffering from myocardial infarction with non-obstructive coronary arteries (MINOCA). Materials and methods. A survey of 62 patients hospitalized to the Republican Clinical and Diagnostic Center of the Ministry of Health of the Republic of Udmurtia with a diagnosis of "myocardial infarction" was conducted, 30 of whom had a single-vessel lesion of the coronary bed, 32 myocardial infarction without coronary artery obstruction. Results. Differences in the clinical manifestations of the acute period were noted by the presence of syncope, isolated shortness of breath, and a difficult-to-explain feeling in the chest. The time from the onset of symptoms to hospitalization in the MINOCA group exceeds 1.7 hours. The MINOCA group had a much higher level of markers of myocardial necrosis (troponin I level of 8.9 ng/ml compared to 1.75 ng/ml), despite a significantly lower frequency of detection of hypokinesia zones and the number of affected segments. Conclusions. It is necessary to improve public awareness of the symptoms of acute coronary syndrome, including its atypical manifestations. Routine PCI does not "save" from subsequent angina pectoris if it is present before MI.