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Review
. 2021 Jul-Sep;11(3):131-138.
doi: 10.4103/ijabmr.IJABMR_210_20. Epub 2021 Jul 19.

The Diagnostic Challenges Associated with Type 2 Myocardial Infarction

Temidayo Abe  1 , Idachaba Samuel  2 , Emmanuel Eferoro  2 , Anyangwa Onyekachi Samuel  2 , Ifure Tom Monday  2 , EstherOlufunke Olunu  2 , Adegbenro Omotuyi Fakoya  3
Affiliations
Review

The Diagnostic Challenges Associated with Type 2 Myocardial Infarction

Temidayo Abe et al. Int J Appl Basic Med Res. 2021 Jul-Sep.

Abstract

The diagnostic challenges associated with type 2 myocardial infarction (T2MI) evolve around an extensive evidence base. T2MI is a type of MI that occurs secondary to ischemia due to increased demand or decreased oxygen supply. This classification has been used for the last 5 years, yet there is little understanding of the characteristics and clinical outcomes. According to a survey, T2M1 can be caused mainly by different factors such as anemia (31%), sepsis (24%), and arrhythmia (17%). Other associated factors, such as age and gender, also play a part in the disease. The pathology behind T2MI is the rise and fall of cardiac troponin values with at least one value above the 99 percentile and evidence of an imbalance unrelated to coronary thrombosis. The diagnosis of the condition is evidence-based backed up with imaging techniques. The treatment of T2MI may involve blood pressure management, administration of blood products, heart rate control, and respiratory support. Depending on the clinical presentation, coronary evaluations can be used to assess the likelihood of coronary artery disease (CAD). If indicated, the MI guidelines may apply to CAD. If it shows, the MI guidelines may use electrocardiography findings of ST-segment elevation myocardial infarction (STEMI) or non-STEMI. However, the absence of CAD indicates that the benefits of cardiovascular risk reduction strategies with T2MI remain uncertain.

Keywords: Arrhythmia; cardiac troponins; coronary heart disease; electrocardiographic; myocardial infarction; type 2 myocardial infarction.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Mechanisms underlying myocardial oxygen demand/supply imbalance leading to type 2 myocardial infarction (n = 144)[17]
Figure 2
Figure 2
The electrocardiography waveforms and segment: PQ segment represents the signal from the SA node to the AV node. The Q wave is produced when the AV nodes releases signals that moves through the interventricular septum. Q, R, and S waves together are referred to as QRS complex which represents the electrical forces produced by ventricular depolarization. R wave is the positive deflection after the P wave. S wave is produced when the basal parts of the ventricles are depolarized
Figure 3
Figure 3
Reciprocal electrocardiography image[14]
Figure 4
Figure 4
Electrocardiography diagnosis of myocardial ischemia with ST-T wave abnormalities which are usually observed with different pathological cardiac conditions
See this image and copyright information in PMC

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