S.D. MAYANSKAYA¹, A.A. GILMANOV², F.N. RIZATDINOVA², M.M. MANGUSHEVA¹, F.R. GUMEROV³ , D.M. AMINOVA¹

¹Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan

²Republican Clinical Hospital, Kazan

³Kazan State Medical Academy — Branch Campus of  RMACPE MH Russia, Kazan

  Contact:

Mayanskaya S.D. ― MD, Professor of the Department of Hospital Therapy

Address: 49 Butlerov Str., Kazan, Russian Federation, 420012, e-mail: Smayanskaya@mail.ru

 In the article, we present a clinical observation of acute myocardial infarction (MI) with ST segment elevation, without Q-wave of the anterior-septal and anterior apical region of the left ventricle of the heart in a 23 y.o. patient with focal-segmental glomerulonephritis, nephrotic syndrome during treatment with glucocorticosteroids and cytostatics. Myocardial infarction was verified using an ECG and Troponin T analysis. ECG IM are presented in dynamics.

This example is used to analyze a number of controversial issues related to the features of dyslipidemia and univascular atherosclerotic lesions of the anterior interventricular branch of the left coronary artery in the presence of other intact vessels. It was noted that after percutaneous coronary angioplasty and stenting, all myocardial ECG changes completely disappeared. The relationship of chronic kidney disease with secondary dyslipidemia and ischemic heart disease in this patient is discussed.

Key words: myocardial infarction with ST segment elevation, young age, nephrotic syndrome, dyslipidemia.

(For citation: Mayanskaya S.D., Gilmanov A.A., Rizatdinova F.N., Mangusheva M.M., Gumerov F.R., Aminova D.M. A case of myocardial infarction with ST segment elevation in a young patient with focal segmental glomerulonephritis (clinical observation). Practical medicine. 2020. Vol. 18, №1, P. 120-125) DOI: 10.32000/2072-1757-2020-1-120-125  

REFERENCES

1. Mukhin I.V. Left ventricular myocardial dysfunction in patients with chronic glomerulo-nephritis and the main approaches to its correction. Nefrologiya, 2003, no. 3, pp. 19-23 (in Russ.).
2. Steg G., Goldberg R.J., Gore J.M. et al. for the GRACE Investigators. Baseline characteristics, management practices, and in-hospital outcomes of patients hospitalized with acute coronary syndromes in the Global Registry of Acute Coronary Events (GRACE). Am. J. Cardiol, 2002, no. 90, pp. 358-363.
3. Ezhov M.V., Sergienko I.V., Aronov D.M. et al. Diagnosis and correction of lipid metabolism disorders for the prevention and treatment of atherosclerosis. Russian recommendations VI revision. Ateroskleroz i dislipidemii, 2017, no. 3 (28), pp. 5-22 (in Russ.).
4. Orth S.R., Ritz E. The nephritic syndrome. N. Engl. Med, 1998, no. 338, pp. 1202-1211.