Infarkt miokarda izazvan koronarnom embolijom nakon operacije srčanih zalistaka
Sažetak
Uvod. Koronarna embolija je redak uzrok infarkta miokarda. Najčešće se povezuje sa atrijalnom fibrilacijom, dilatativnom kardiomiopatijom, bakterijskim endokarditisom i hiperkoagulabilnim stanjem, kao i sa operacijom srca. Prikaz bolesnika. Prikazan je slučaj bolesnika sa teškom mitralnom i trikuspidnom regurgitacijom, bez postojeće koronarne bolesti. Urađena je operacija srčanih zalistaka, a neposredni postoperativni tok je protekao uredno. Pet dana posle operacije došlo je srčanog zastoja koji je bio praćen uspešnim reanimacionim postupkom. Elektrokardiografski je registrovana atrijalna fibrilacija sa značajnom elevacijom ST segmenta u inferiornim odvodima. Urgentna koronarna angiografija je pokazala totalnu okluziju desne koronarne arterije, te se pristupilo perkutanoj koronarnoj intervenciji kojom je uspešno uspostavljen ponovni protok kroz arteriju. Bolesnik je otpušten 20. postoperativnog dana, sa trojnom antitrombotskom terapijom. Zaključak. Operacija srca može biti praćena neočekivanim i potencijalno fatalnim komplikacijama, među kojima je i koronarna embolija. Brza i adekvatna reakcija medicinskog tima ključna je za preživljavanje i oporavak bolesnika.
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