TYPE 2 MYOCARDIAL INFARCTION: DIAGNOSTIC AND THERAPEUTIC DIFFICULTIES IN MODERN CARDIOLOGY

Highlights Diagnosis and management of type 2 myocardial infarction present significant challenges nowadays due to variety of its etiological factors and clinical manifestations. The correct and definitive identification of type 2 myocardial infarction is of paramount importance, since the treatment in most cases differs significantly from that of type 1 myocardial infarction. Abstract Cardiovascular diseases are the leading cause of morbidity and mortality among both sexes in developing countries, accounting for a third of all deaths worldwide and almost 50% of all deaths in Europe – more than 4 million annually. Death from cardiovascular diseases accounts for almost half of all cases of mortality in the Russian Federation. Type 2 MI (MI2), defined as MI, developing as a result of an acute imbalance in myocardial oxygen supply and demand without atherothrombosis, has become a very common clinical phenomenon, and it is currently detected twice as often as before. Differential diagnosis between MI1 and MI2 is often difficult. Nevertheless, the correct and definitive identification of MI2 is of paramount importance, since the treatment in most cases differs significantly from that of MI1. The existing clinical guidelines for the management of patients with ACS without STEMI do not affect the algorithm of diagnosis and treatment of MI2, since they mainly relate to MI1. With such a large number of uncertainties regarding the treatment of MI2, there is an urgent need to develop validated recommendations for the diagnosis and treatment of this type of MI. In this article, we propose an algorithm for the diagnosis of MI2, developed on the basis of data from modern literature.