نبذة مختصرة : Purpose. To determine the incidence of type 2 myocardial infarction (MI) diagnosis (according to the Fourth Universal Definition) and the features of patient management in real clinical practice.Material and Methods. A retrospective study was performed by analyzing the case histories of 153 patients diagnosed with acute coronary syndrome (ACS). Inclusion criteria were the presence of ACS at admission followed by a confirmed diagnosis of MI during the hospital period according to the Fourth Universal Definition of MI and the age of patients > 18 years. Patients with severe comorbidities affecting the immediate prognosis and/or being an alternative to the diagnosis of MI were not included in the study.Results. The study showed that emergency coronary angiography was performed in 151 patients (98.7%). A decrease in the renal filtration function in the presence of chronic kidney disease was a contraindication to this study found in 1.3% of cases; 12 (8%) patients did not have coronary artery disease or had stenoses of less than 50%; these patients comprised the group of patients with type 2 MI. While analyzing the results of examination in patients with type 2 MI, ST segment elevation was detected in seven patients (58.4%) according to electrocardiography; ST segment depression was observed in one patient (8.3%); complete left bundle-branch block was found also in 1 case (8.3%), three individuals (25%) did not have any changes in the position of ST segment, but had a negative T wave. Analysis of possible etiological factors in the development of type 2 MI showed the presence of sinus tachycardia in two patients (16.7%), severe sinus bradycardia in one patient (8.3%), fl utter paroxysm and atrial fibrillation with tachysystole throughout the ventricles in two patients (16.7%), and history of atrial fibrillation in one patient (8.3%).Conclusion. Type 2 MI was diagnosed in 8% of patients with ACS with and without ST segment elevation where cardiac arrhythmias including sinus arrhythmias may be the potential ...
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