Post-infections and sepsis associated myocardial infarction: casuistic masks


  • L.O. Malsteva Dnipropetrovsk State Medical Academy, Dnipro, Ukraine
  • W.W. Nikonov Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
  • N.A. Kazimirova Dnipropetrovsk State Medical Academy, Dnipro, Ukraine
  • A.A. Lopata Dnipropetrovsk State Medical Academy, Dnipro, Ukraine



myocardial infarction, universal definitions, casuistic masks, review


The review aims to present the chronological sequence of developing universal definitions of myocardial infarction, new ideas for improving the screening of post-infectious and sepsis-associated myocardial infarction (MI) (casuistic masks of myocardial infarction). The stages of the development of the common and global definition of myocardial infarction are outlined: 1 — by WHO working groups based on ECG for epidemiological studies; 2 — by the European Society of Cardiology and the American College of Cardio-logy using clinical and biochemical approaches; 3 — the Global Task Force consensus document of universal definition with subsequent classification of MI into five subtypes (spontaneous, dissonance in oxygen delivery and consumption; lethal outcome before the rise of specific markers of myocardial damage; PCI-associated; CABG- associated); 4 — review by the Joint Task Force of the above document based on the inclusion of more sensitive markers — troponins; 5 — the allocation of 17 non-ischemic myocardial damage, accompanied by an increase in the level of troponin; 6 — characteristic of the atrial natriuretic peptide from the standpoint of its synthesis, storage, release, diagnostic value as a biomarker of acute myocardial dama­ge; 7 — a clinical definition of myocardial infarction, presented in materials of the III Consensus on myocardial infarction 2017. The diagnosis of myocardial infarction using the criteria set in this document requires the integration of clinical data, ECG patterns, laboratory data, imaging findings, and, in some cases, pathological results, which are considered in the context of the time frame of the suspec­ted event. K. Thygesen et al. consider the additional use of: 1) cardiovascular magnetic resonance to determine the etiology of myocardial damage; 2) computer coronary angiography with suspected myocardial infarction. Myocardial infarction is a combination of specific cardio markers with at least one of the symptoms listed above. The formation of myocardial infarction can occur during/after acute respiratory infection. Causal relationships between these two states are established. Post-infectious myocardial infarction is strongly recommended to be individualized as a separate diagnostic entity. In sepsis, global myocardial ischemia with ischemic myocardial damage arises as a result of humoral and cellular factors, accompanied by an increase in troponins, a decrease in the ejection fraction of the left ventricle by 45 % and an increase in the final diastolic size of the left ventricle, the development of sepsis-associated multiple organ fai­lure, which is an unfavourable prognosis factor.


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