Article ; Online: Type 2 myocardial infarction: a diagnostic and therapeutic challenge in contemporary cardiology.
Internal and emergency medicine
2022 Volume 17, Issue 2, Page(s) 317–324
Abstract: In the expanding world of cardiovascular diseases, rapidly reaching pandemic proportions, the main focus is still on coronary atherosclerosis and its clinical consequences. However, at least in the Western world, middle-aged male patients with acute ... ...
| Abstract | In the expanding world of cardiovascular diseases, rapidly reaching pandemic proportions, the main focus is still on coronary atherosclerosis and its clinical consequences. However, at least in the Western world, middle-aged male patients with acute myocardial infarction are no more the rule. Due to a higher life expectancy and major medical advances, physicians are to treat older and frailer individuals, usually with multiple comorbidities. In this context, myocardial ischaemia and infarction frequently result from an imbalance between myocardial oxygen supply and demand-i.e., type 2 myocardial infarction (T2MI), according to the current universal definition-rather than coronary atherothrombosis. Moreover, the increasing use of high-sensitivity cardiac troponin assays has led to a heightened detection of T2MI-often causing relatively little myocardial injury-, which seems to have doubled its numbers in recent years. Nevertheless, owing to its multifaceted pathophysiology and clinical presentation, T2MI is still underdiagnosed. Perhaps more importantly, T2MI is also victim of undertreatment, as drugs that constitute the cornerstone of therapy in most cardiovascular diseases are much more unlikely to be prescribed in T2MI than in coronary atherothrombosis. In this paper, we review the recent literature on the classification, pathophysiology, epidemiology, and management of T2MI, trying to summarise the state-of-the-art knowledge about this increasingly important pathologic condition. Finally, based on the current scientific evidence, we also propose an algorithm that may be easily utilised in clinical practice, in order to improve T2MI diagnosis and risk stratification. |
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| MeSH term(s) | Biomarkers ; Cardiology ; Coronary Artery Disease ; Heart ; Heart Injuries ; Humans ; Male ; Middle Aged ; Myocardial Infarction/drug therapy ; Myocardial Infarction/therapy |
| Chemical Substances | Biomarkers |
| Language | English |
| Publishing date | 2022-02-14 |
| Publishing country | Italy |
| Document type | Journal Article ; Review |
| ZDB-ID | 2454173-4 |
| ISSN | 1970-9366 ; 1828-0447 |
| ISSN (online) | 1970-9366 |
| ISSN | 1828-0447 |
| DOI | 10.1007/s11739-021-02920-8 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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