Discordance between the Clinical Presentation and Morphology of Myocardial Infarction in a Patient with Acute post-Hemorrhagic Anemia

Truong Huy Hoang; Pavel V. Lazarev, MD, PhD; Victor V. Maiskov, MD, PhD; Meray Imad, MD, PhD; Zhanna D. Kobalava, DMedSc

doi:10.18502/jthc.v15i3.4225

Journal of Tehran University Heart Center (Jul 2020)

Discordance between the Clinical Presentation and Morphology of Myocardial Infarction in a Patient with Acute post-Hemorrhagic Anemia

Truong Huy Hoang,
Pavel V. Lazarev, MD, PhD,
Victor V. Maiskov, MD, PhD,
Meray Imad, MD, PhD,
Zhanna D. Kobalava, DMedSc

Affiliations

Truong Huy Hoang: Department of Internal Diseases, Medical Institute, RUDN University, Moscow, Russia.
Pavel V. Lazarev, MD, PhD: Department of Internal Diseases, Medical Institute, RUDN University, Moscow, Russia.
Victor V. Maiskov, MD, PhD: 1- Department of Internal Diseases, Medical Institute, RUDN University, Moscow, Russia. 2- Vinogradov City Clinical Hospital, Moscow, Russia.
Meray Imad, MD, PhD: 1-Department of Internal Diseases, Medical Institute, RUDN University, Moscow, Russia. 2- Vinogradov City Clinical Hospital, Moscow, Russia.
Zhanna D. Kobalava, DMedSc: Department of Internal Diseases, Medical Institute, RUDN University, Moscow, Russia.

DOI: https://doi.org/10.18502/jthc.v15i3.4225
Journal volume & issue: Vol. 15, no. 3

Abstract

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While atherosclerotic plaque disruption remains the hallmark of type 1 myocardial infarction (T1MI), multiple other mechanisms provoking myocardial supply/demand mismatch (eg, anemia and tachyarrhythmias) are recognized as the potential causes of type 2 myocardial infarction (T2MI). In clinical practice, angiography is underutilized in patients with MI that have typical T2MI triggers, although the presence of these triggers and various forms of atherosclerotic coronary artery disease is not mutually exclusive. We describe a 70-year-old man that developed MI during hospitalization for gastrointestinal bleeding. He was treated conservatively without angiography due to posthemorrhagic anemia, which is a recognized T2MI trigger, and subsequently developed refractory cardiogenic shock. Autopsy revealed atherothrombosis, which is characteristic of T1MI.

Published in Journal of Tehran University Heart Center

ISSN: 1735-8620 (Print); 2008-2371 (Online)
Publisher: Tehran University of Medical Sciences
Country of publisher: Iran, Islamic Republic of
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://jthc.tums.ac.ir

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