ABSTRACT
Tako-tsubo cardiomyopathy is new clinical syndrome which mimic acute myocardial infarction. The main characteristic is apical ballooning of the left ventricular wall during systole and normal findings on coronary arteries. Pathophysiology is not known, very important is definitively the role of catecholamines. The electrocardiography, echocardiography, left ventricular angiography and coronary angiography are methods used in diagnosis of this syndrome. The therapy is only symptomatic, in cases with severe complications mechanical support of circulation should be used.
Subject(s)
Takotsubo Cardiomyopathy/diagnosis , Humans , Takotsubo Cardiomyopathy/physiopathology , Takotsubo Cardiomyopathy/therapyABSTRACT
The incidence of atherosclerosis is very high and the typical risk factors such as lipids, blood pressure, smoking, dietary habits and lifestyle in general have an 80% share in its development. Heredity also has a significant share and genome-related information has been given growing attention in recent years. A number of links between polymorphisms found at certain gene positions and the probability of acute myocardial infarction at a young age have been currently described. Cross-sectional studies have been focused on the identification of particular genotypes and alleles which can be responsible for early development of atherosclerosis and acute myocardial infarction. The article summarises some of the knowledge acquired so far in the field of genetic makeup of patients with acute myocardial infarction.
Subject(s)
Myocardial Infarction/genetics , Chromosome Aberrations , Coronary Artery Disease/genetics , Genotype , Humans , Hypertension/genetics , Mutation , Polymorphism, GeneticABSTRACT
Remodelling of the left ventricle after myocardial infarction is a major cause of the heart failure development with possible death. Despite application of pharmacological, catheter and surgical interventions and the use of new mechanical devices, the myocardium lost during myocardial infarction cannot be regenerated. Implantation of bone-marrow stem cells into the heart might be a new method to restore myocardial viability. In animal experiments, attempts to replace fibrotic zone by transplanting stem cells have regularly succeeded in reconstituting myocardial structure--cardiomyocytes and capillary vessels. Repair of myocardium using bone-marrow derived multipotent stem cells was shown in experimental and in the first few clinical studies. Current status of our knowledge about the use of stem cells in the myocardial regeneration is described in this article, as well as the cautions, which are necessary during early period of this mode of treatment in humans.
Subject(s)
Myocardium/cytology , Regeneration , Stem Cell Transplantation , Animals , Humans , Myocardial Infarction/therapyABSTRACT
Direct PTCA is a treatment of choice in patients with acute myocardial infarction with ST segment elevations (STEMI). Fibrinolysis remains important modality of treatment in these patients. Currently, there are more then 100 tissue plasminogen activator mutants available with different fibrin specificity. In a clinical practice, tissue-type plasminogen activator (t-PA), recombinant tissue-type plasminogen activator (rt-PA), tenecteplase (TNK-tPA) and lanoteplase (n-PA) are most important examples. Fibrinolytic treatment in STEMI patients should be used in patients presenting in first 4 hours after beginning of chest pain, when it is sure, that direct PTCA cannot be started within next 90 minutes. Concomittant therapy of acute STEMI patients consists of anticoagulans, antiplatelet and antiagregatory treatment.
