Microcirculation Measurements in Critical and Non-critical Myocardial Ischemia / ; Mikrocirkuliacijos tyrimai kritinės ir nekritinės miokardo išemijos atvejais.

The microcirculation plays an important role in the pathogenesis of acute coronary syndromes, especially in type 2 myocardial infarction, myocardial infarction with non-obstructive coronary arteries and cardiogenic shock. Disturbances in the microcirculation can lead to hypoxia and reduced tissue perfusion, which can be particularly dangerous for cardiac muscle tissue, which requires a constant supply of oxygen and nutrients. The main objectives of this study were to introduce a method of monitoring systemic microcirculatory parameters in the treatment of patients with cardiogenic shock, to assess the effect of microcirculation on the prognosis of cardiogenic shock and to determine the prevalence of myocardial infarction with non-obstructive coronary arteries and type 2 myocardial infarction in clinical practice. The study included patients with myocardial infarction and cardiogenic shock, patients with type 2 myocardial infarction and patients with unstable angina. A direct correlation was found between microcirculatory parameters and treatment outcome in patients with cardiogenic shock. It was observed that type 2 myocardial infarction is very rarely detected in clinical practice. It was found that a significant proportion of patients diagnosed with unstable angina could be reclassified as myocardial infarction. Recommendations for the use of microcirculation and the possible diagnostic algorithm of type 2 myocardial infarction treatment are provided. The thesis is written in English and illustrated with figures and tables. The dissertation consists of a list of abbreviations, introduction, literature review, methodology, results and discussion, conclusions, publications and reference list.