| Avtor/Urednik | Remškar, Mojca; Kranjec, Igor; Horvat, Matija; Noč, Marko | |
| Naslov | Pojav zadržanega pretoka pri bolniku z akutnim miokardnim infarktom | |
| Prevedeni naslov | "No reflow" phenomenon in a patient with acute myocardial infarction | |
| Tip | članek | |
| Vir | Zdrav Vestn | |
| Vol. in št. | Letnik 69, št. 4 | |
| Leto izdaje | 2000 | |
| Obseg | str. 249-51 | |
| Jezik | slo | |
| Abstrakt | Background. Acute myocardial infarction is caused by thrombotic occlusion of epicardial coronary artery. Recanalization of the culprit coronary artery by thrombolysis or mechanically by percutaneous transluminal intracoronary angioplasty (PTCA) is the most important therapeutic intervention. Successful and complete recanalization of the culprit artery, however, does not always result in reperfusion of the ischemic myocardium. This phenomenon is regarded as "no reflo" and is a result of reperfusion deficit at the level of microcirculation. Treatment strategies for "no reflow" phenomenon include intracoronary drugs such as nitroglicerin, verapamil, adenosine or papaverin, and intravenous abciximab. Also intraaortic baloon counterpulsation may be of benefit. However, none of this intervention has been unequivocaly shown to improve left ventricular function and ultimate survival of patients after acute myocardial infarction. Conclusions. The aim of this article is to presents patient with "no reflow" phenomenon after successful recanalization of infarct related artery by primary PTCA. | |
| Izvleček | Izhodišča. Akutni miokardni infarkt nastane zaradi trombotične zapore epikardialne koronarne arterije. Pri takem bolniku je treba tromb čimprej raztopiti s trombolizo ali mehanično odstraniti s perkutano transluminalno koronarno angioplastiko (PTCA). Uspešna in popolna rekanalizacija koronarne arterije pa vedno ne vzpostavi zadovoljivega pretoka skozi prizadeti miokard. Ta pojav imenujemo "no reflow ali zadržani pretok". Nastane zaradi okvare mikrocirkulacije v ishemični srčni mišici. V takem primeru koronarni pretok poskušamo izboljšati z nekaterimi zdravili, kot so intrakoronarni nitroglicerin, verapamil, adenozin ali papaverin ter intravenski abciximab. Uporabimo lahko tudi intraaortno balonsko črpalko. Za nobenega od naštetih načinov pa ni dokončno jasno, ali res izboljša delovanje levega prekata in s tem preživetje bolnikov po akutnem miokardnem infarktu. Zaključki. Namen našega prispevka je prikazati bolnika s pojavom zadržanega pretoka, ki smo ga opazovali po uspešni rekanalizaciji infarktne koronarne arterije s primarno PTCA. | |
| Deskriptorji | MYOCARDIAL INFARCTION ANGIOPLASTY, TRANSLUMINAL, PERCUTANEOUS CORONARY THROMBOLYTIC THERAPY MIDDLE AGE MYOCARDIAL REPERFUSION NITROGLYCERIN |