Ali DUYGU, Bahadır KIRILMAZ, Mustafa REŞORLU

COVID-19 pandemi döneminde koroner arter hastalığına hibrit yaklaşım

Koroner arter hastalığı (KAH), dünya çapında yaygın bir morbidite ve mortalite nedenidir. KAH, stabil anjina, stabil olmayan anjina, miyokardiyal enfarktüs (MI) veya ani kalp ölümü ile kendini gösteren aterosklerotik bir hastalıktır. Koroner arter hastalığının tanı ve girişimsel tedavisi için tüm dünyada kullanılan koroner anjiyografi COVID 19 pandemisinde enfeksiyon riski nedeniyle daha az tercih edilmektedir. 42 yaşında erkek hasta, polikliniğimize 15 gündür devam eden göğüs ağrısı şikayeti ile başvurdu. Hastamız için en etkili ve faydalı yöntemin koroner BT anjiyografi olduğu düşünülerek aile öyküsü olduğu bilinen hastaya merkezimizde koroner BT anjiyografi yapılmasına karar verildi. Kateter koroner anjiyografi altın standart olmasına rağmen, koroner BT anjiyografi, plak tipini ve koroner tıkanıklığın şiddetini kolayca belirleyebilen ve koroner arterlerdeki plağın doğrudan görüntülenmesini sağlayan non-invaziv bir tanı testi olarak giderek daha fazla kullanılmaktadır. 2019 ESC Kronik Koroner Arter Hastalığı Kılavuzuna göre, koroner BT anjiyografi, daha düşük klinik KAH olasılığı olan, önceden KAH tanısı olmayan ve daha yüksek görüntü kalitesi olasılığı ile ilişkili özellikleri olan hastalarda tercih edilen testtir. Etkileri, koroner BT anjiyografinin doğru tanısal özelliği, pandemi dönemde temas riskini azalttığı ve uygulanan kontrast madde miktarını azaltmaya yardımcı olduğu için kullanışlılığını korumaktadır.

Anahtar Kelimeler:

koroner arter hastalığı, koroner bilgisayarlı tomografi anjiyografi, COVID-19

Hybrid Approach to Coronary Artery Disease During the COVID-19 Pandemic Period

Coronary artery disease (CAD) is a common cause of morbidity and mortality worldwide. CAD is an atherosclerotic disease manifested by stable angina, unstable angina, myocardial infarction (MI) or sudden cardiac death. In the COVID 19 pandemic, coronary angiography, which is used for the diagnosis and interventional treatment of coronary artery disease for diagnostic purposes all over the world, is less preferred due to the risk of infection. A 42-year-old male patient was admitted to our outpatient clinic with chest pain for 15 days. Considering that the most effective and beneficial method for our patient was coronary CT angiography, it was decided to perform coronary CT angiography in our center on the patient with a known family history. Although catheter coronary angiography is the gold standard, coronary CT angiography is increasingly used as a non-invasive diagnostic test that can easily identify the type of plaque and the severity of coronary occlusion and provides direct visualization of the plaque in the coronary arteries. According to the 2019 ESC Chronic Coronary Artery Disease Guidelines, coronary CT angiography is the test of choice in patients with a lower clinical probability of CAD, no previous diagnosis of CAD, and features associated with a higher likelihood of image quality.Although it has side effects, the accurate diagnostic feature of coronary CT angiography maintains its usefulness as it reduces the risk of contact during the pandemic period and helps to reduce the amount of contrast agent administered.

Keywords:

Coronary Artery Disease, coronary computed tomography angiography, COVID-19,

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