Key result
Autopsy reveals type 1 myocardial infarction with atherothrombosis clinically presumed to be type 2.
Why the study?
The clinical triggers of type 2 myocardial infarction and morphological signs of type 1 myocardial infarction may be discordant, complicating diagnosis and management.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
Clinical type 2 myocardial infarction diagnosis may overlook atherothrombosis in anemic patients; leaves open accuracy of current supply-demand criteria.
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.
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Hoang et al. (2020) conducted a case report in Myocardial infarction (n=1). Conservative therapy without coronary angiography or antithrombotics was evaluated on Autopsy findings. Autopsy revealed type 1 myocardial infarction with atherothrombosis in a patient clinically presumed to have type 2 myocardial infarction secondary to post-hemorrhagic anemia.
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