Репозиторий Университета

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: Presentation of diagnostic possibilities of volume computed tomography (VCT) of a heart combined with pharmacological vasodilation agent adenosine triphosphate (ATP) test in estimation of myocardial perfusion and detection of left ventricle myocardial ischemia diagnosis with non-obstructive coronary arteries. Materials and methods: VCT combined with ATP test was performed at female 53-year-old patient with non-obstructive coronary arteries verified by coronary angiography. The VCT «Aqulion ONE 640 Vision Edition» (Toshiba, Japan) was used. The non-ionic iodinecontaining contrast agent Ultravist-370 (Bayer, Germany) was infused in a quantity of 60 ml at rest and during ATP test. The clinical and instrumental data were also performed. Conclusion: The presented clinical case shows the possibilities in myocardial ischemia of the left ventricle in non-obstructive coronary arteries diagnostics by a volume CT combined with ATP pharmacological test.

© 2018 Stolichnaya Izdatelskaya Kompaniya. Acute myocardial infarction (AMI) is one of the main causes of morbidity and mortality, both in the Russian Federation and around the world. Approximately, in up to 10% of patients with clinical diagnostic features of AMI, early angiography does not reveal an occluded vessel or possibly any evidence of coronary artery disease. These patients constitute an intriguing subgroup referred to as "Myocardial Infarction with Non-Obstructive Coronary Arteries" (MINOCA). MINOCA is a collective concept that unites many different pathologies, which determines the essential heterogeneity of the etiological factors. Coronary artery embolism is recognized as an important non-atherosclerotic cause of AMI. In turn, the most common underlying disease in those with coronary embolism is the atrial fibrillation. The advantages of reperfusion strategy and cardioprotective therapy in the treatment of obstructive arteriosclerosis are well studied, widely presented in the literature and supported by a strong evidence base, while the issues of diagnosis and treatment of patients with MINOCA are currently widely discussed We present two clinical cases of embolic myocardial infarction in patients with atrial fibrillation, diagnosed in our clinic in 2017..