Eroglu Serkan Emre, Ademoglu Enis, Bayram Samet, Aksel Gökhan
Health Sciences University, Umraniye Research and Training Hospital, Department of Emergency Medicine, Istanbul, Turkey.
Medeni Med J. 2021;36(1):63-68. doi: 10.5222/MMJ.2021.25478. Epub 2021 Mar 26.
Myocardial infarction with nonobstructive coronary arteries (MINOCA) is defined as having a stenosis of less than 50% or no stenosis in coronary angiography in a patient diagnosed with myocardial infarction. Because of its thrombogenic predisposition in COVID-19, the diagnosis of MINOCA syndrome is rarely thought in the patients with ST-segment elevation myocardial Infarction on electrocardiogram. In this case report, we discuss a 47-year-old male patient diagnosed with MINOCA who was followed up with respiratory failure due to COVID-19 viral pneumonia in intensive care unit. His 12-lead electrocardiogram showed "inferior STEMI". A 30-40% stenosis was also shown in the midportion of left anterior descending artery in emergency coronary angiography. The patient had a normal computed tomographic pulmonary angiography and was discharged with a full recovery. MINOCA may be triggered by hyperinflammation or various processes due to COVID-19. To explain these processes associated with MINOCA syndrome, further clinical trials are needed.
非阻塞性冠状动脉心肌梗死（MINOCA）的定义为，在被诊断为心肌梗死的患者中，冠状动脉造影显示狭窄小于50%或无狭窄。由于COVID-19具有血栓形成倾向，对于心电图显示ST段抬高型心肌梗死的患者，很少会考虑MINOCA综合征的诊断。在本病例报告中，我们讨论了一名47岁男性患者，他被诊断为MINOCA，在重症监护病房因COVID-19病毒性肺炎并发呼吸衰竭接受治疗。他的12导联心电图显示“下壁ST段抬高型心肌梗死”。急诊冠状动脉造影显示左前降支中段有30%-40%的狭窄。患者的计算机断层扫描肺血管造影正常，出院时已完全康复。MINOCA可能由COVID-19引起的过度炎症或各种过程触发。为了解释这些与MINOCA综合征相关的过程，还需要进一步的临床试验。
