Type 2 Myocardial Infarction in Acute Medical Care

Abstract

AbstractBackground: Type 2 myocardial infarction (MI) is defined as MI secondary to ischemia due to either increased oxygen demand or decreased supply. It is seen in conditions other than coronary artery disease (CAD) contributes to an imbalance between myocardial oxygen supply and/or demand. Little is known about patient characteristics and clinical outcomes.Methods: A retrospective analysis was performed in patients who were admitted in acute medical care with symptoms suggestive of myocardial ischemia and enzymatic elevation from January 2015 to December 2015. Patients with slight elevation (above the upper limit of normal) of CK-MB were included in the study and compared the clinical and laboratory profile between men and women.Results: This survey includes a total of 54 patients, Out of which complete details were available in 41 patients (M:23; F:18). The mean age was 42.61. The common causes of type-II MI were Infectious (M:9 (39.1%), F:10 (55.6%) followed by haematological disorders (M:3 (13%), F:5 (27.7%). The mean CK-MB was 28.00. The mean CPK was 122.5. There was no hypotension, renal failure at the time of admission. One patient had in-hospital mortality out of all patients, whose primary diagnosis was septicaemia with shock who had normal CPK, elevated CK-MB and elevated NT pro BNP levels. Patients with type-II MI were not referred for coronary interventions and managed conservatively.Conclusions: There is no significant difference in the risk for type 2 MI between men and women. Clinical suspicion and diagnosis of type 2 MI is crucial in acute medical care setting, as the mortality can be reduced with adequate management of underlying condition. The threshold of biomarker levels should be low (above the upper limit of normal in symptomatic ischemia) to label type 2 MI contrary to the third universal definition of MI.