Nyeri dada dari penyebab non aterosklerosis: Pendekatan patologi arteri koroner
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Abstract
Tanda-tanda patologis non-aterosklerotik pada arteri koroner meliputi berbagai penyakit yang dapat menyebabkan iskemia miokard, terlepas dari masalah plak dan penyempitan serta obstruksi lumen yang diakibatkannya. Individu-individu ini sering menunjukkan gejala nonspesifik seperti sesak napas, cepat lelah, dan nyeri dada saat beraktivitas. Ketika penyebab yang mendasarinya bukan aterosklerotik, temuan ini umumnya diabaikan dalam laporan radiologi sebagai kemungkinan diagnosis banding. Kami mencari artikel di Medline (melalui PubMed) yang melaporkan tentang kelainan patologis non-oklusif yang tidak biasa pada arteri koroner. Studi literatur dilakukan dalam format naratif, dengan tujuan untuk meringkas temuan utama penyakit non-oklusif seperti jembatan miokard, aneurisma koroner, ektasia, dan fistula. Anomali non-aterosklerotik pada dinding arteri koroner harus diperiksa ketika menentukan etiologi ketidaknyamanan dada, dispnea, dan aritmia, karena dapat mengakibatkan iskemia miokard akut dan kronis. Kelainan arteri koroner non-aterosklerotik perlu dipertimbangkan sebagai diagnosis banding pada pasien dengan nyeri dada, dispnea, atau aritmia, terutama ketika tidak ditemukan stenosis aterosklerotik yang bermakna. Pemilihan modalitas pencitraan yang tepat berperan penting dalam menegakkan diagnosis sehingga tata laksana dapat diberikan secara optimal.
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