Sinkopa kao početni simptom ostijalne lezije glavnog stable leve koronarne arterije sa kardiogenim šokom

Milovan Petrović; Igor Ivanov; Bojan Vujin; Vladimir Ivanović; Aleksandar Redžek

doi:10.2298/4006

Milovan Petrović Clinic for Cardiology, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Igor Ivanov Clinic for Cardiology, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Bojan Vujin Clinic for Cardiology, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Vladimir Ivanović Clinic for Cardiology, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Aleksandar Redžek Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; Clinic for Cardiovascular Surgery, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Novi Sad, Serbia

DOI: https://doi.org/10.2298/4006

Ključne reči: myocardial infarction||, ||infarkt miokarda, syncope||, ||sinkopa, shock, cardiogenic||, ||šok, kardiogeni, coronary angiography||, ||angiografija koronarnih arterija, drug-eluting stents||, ||stentovi, lekom obloženi,

Sažetak

Uvod. Sinkopa predstavlja relativno netipičan simptom akutnog koronarnog sindroma. Sama sinkopa ne pruža dovoljno informacija za dijagnozu akutnog koronarnog događaja, naročito lezije glavnog stabla leve koronarne arterije, bez malignih poremećaja ritma i provođenja. Prikaz bolesnika. Bolesnik, star 63 godine, primljen je u jedinicu intenzivne kardiološke nege zbog kratkotrajnog gubitka svesti, u sinus tahikardiji, sa znacima akutne srčane slabosti, hipotenzivan. Elektrokardiogram je pokazivao suspektne znake za razvoj akutnog infarkta miokarda prednjeg zida. Zbog toga, kao i zbog razvoja početnog kardiogenog šoka, indikovana je i urađena urgentna koronarografija (subokluzivna lezija ostijuma glavnog stabla leve koronarne arterije) i primarna perkutana koronarna intervencija sa implantiranom intraaortnom balon pumpom. Direktno je ugrađen stent obložen lekom sa optimalnim primarnim rezultatom. Zaključak. Brza dijagnoza, naročito sa ovakvom relativno atipičnom kliničkom slikom, brza primena reperfuzione terapije u vidu primarne perkutane koronarne intervencije u akutnom infarktu miokarda komplikovanim kardiogenim šokom, doprinosi poboljšanju preživljavanja i kvalitetu života bolesnika. Ovaj prikaz bolesnika klinički je poučan zbog relativno atipične prezentacije i izvršenih intervencija.

Biografije autora

Milovan Petrović, Clinic for Cardiology, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia

Docent Medicinskog fakulteta Univerziteta u Novom Sadu

Igor Ivanov, Clinic for Cardiology, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia

Docent Medicinskog fakulteta Univerziteta u Novom Sadu

Bojan Vujin, Clinic for Cardiology, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia

Docent Medicinskog fakulteta Univerziteta u Novom Sadu

Vladimir Ivanović, Clinic for Cardiology, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia

Asistent Medicinskog fakulteta Univerziteta u Novom Sadu

Aleksandar Redžek, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; Clinic for Cardiovascular Surgery, Institute for Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Novi Sad, Serbia

Docent Medicinskog fakulteta Univerziteta u Novom Sadu

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