ssmuБюллетень сибирской медициныBulletin of Siberian Medicine1682-03631819-3684Siberian State Medical University, the Ministry of Healthcare of the Russian Federation10.20538/1682-0363-2021-2-228-232ssmu-4401Research ArticleСЛУЧАЙ ИЗ КЛИНИЧЕСКОЙ ПРАКТИКИCLINICAL CASESТромбоэмболия легочной артерии в сочетании с острым инфарктом миокарда: клинический случайPulmonary embolism with comorbid acute myocardial infarction: a clinical casehttps://orcid.org/0000-0002-7384-9705ЗахарьянЕ. А.ZakharyanE. A.

 канд. мед. наук, доцент, кафедра внутренней медицины № 1 с курсом клинической фармакологии

Россия, 295006, Республика Крым, г. Симферополь, бульвар Ленина, 5/7

5/7, Lenina Av., Simferopol, Republic of Crimea, 295051, Russian Federation

https://orcid.org/0000-0001-7390-9109ГригорьевП. Е.GrigorievP. E.

 д-р биол. наук, доцент, профессор кафедры «Психология»; вед. науч. сотрудник

Россия, 295053, Республика Крым, г. Севастополь, ул. Университетская, 22

Россия, 298603, Республика Крым, г. Ялта, ул. Мухина, 10

33, Universitetskaya Str., Sevastopol, Republic of Crimea, 299053, Russian Federation

10, Mukhina Str., Yalta, Republic of Crimea, 298603, Russian Federation

https://orcid.org/0000-0003-2248-5400ШатовД. В.ShatovD. V.

 канд. мед. наук, доцент, кафедра общей хирургии, анестезиологии-реаниматологии и скорой медицинской помощи

Россия, 295006, Республика Крым, г. Симферополь, бульвар Ленина, 5/7

5/7, Lenina Av., Simferopol, Republic of Crimea, 295051, Russian Federation

dmitrii_shatov@mail.ruМедицинская академия (МА) имени С.И. Георгиевского, Крымский федеральный университет (КФУ) имени В.И. ВернадскогоРоссияMedical Academy named after S.I. Georgievsky, V.I. Vernadsky Crimean Federal UniversityRussian FederationСевастопольский государственный университет; Академический научно-исследовательский институт физических методов лечения, медицинской климатологии и реабилитации имени И.М. Сеченова (АНИИ им. И.М. Сеченова)РоссияSevastopol State University; Academic Research Institute of Physical Treatment Methods, Medical Climatology and Rehabilitation named after I.M. SechenovRussian Federation202118072021202228232Copyright © Захарьян Е.А., Григорьев П.Е., Шатов Д.В., 20212021Захарьян Е.А., Григорьев П.Е., Шатов Д.В.Zakharyan E.A., Grigoriev P.E., Shatov D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://bulletin.ssmu.ru/jour/article/view/4401

 Представлен случай сочетания тромбоэмболии легочной артерии и острого нижнего инфаркта миокарда у 54-летнего пациента, который поступил в региональный центр по проведению чрескожных коронарных вмешательств. При выполнении коронароангиографии обнаружено  многососудистое поражение с ангиографическими признаками нестабильности в проксимальной трети правой коронарной артерии, при ангиопульмонографии – картина тромбоэмболии легочной артерии с нарушением перфузии легких средней степени тяжести.Описанное сочетание представляет собой трудную задачу  как с точки зрения диагностики, так и последующей лечебной тактики. Особенностью данного случая является  применение двойного интервенционного вмешательства, состоящего из реваскуляризации инфаркт-зависимой  артерии и фрагментации тромботических масс в легочной артерии в сочетании с тромболитической терапией.  

 The article presents a case of pulmonary embolism with comorbid acute inferior myocardial infarction in the 54-year-old patient who was admitted to the Regional Center for Percutaneous Coronary Interventions. Coronary angiography revealed a multivessel lesion with angiographic signs of instability  in the proximal third of the right coronary artery. Pulmonary angiography revealed signs of pulmonary embolism with moderate impairment of pulmonary perfusion.The described combination is challenging in terms of both diagnosis and subsequent treatment strategy. A feature of this case is the use of a double surgery, consisting of revascularization of the infarct-related artery and fragmentation of thrombotic masses in the pulmonary artery, in combination with thrombolytic therapy. 

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The authors declare that there are no conflicts of interest present.