No reflow phenomenon

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No-reflow phenomenon
Synonyms
Pronounce N/A
Specialty N/A
Symptoms Impaired blood flow despite open coronary artery
Complications Myocardial infarction, heart failure
Onset During or after percutaneous coronary intervention
Duration Variable
Types N/A
Causes Microvascular obstruction, endothelial dysfunction
Risks Diabetes mellitus, hypertension, hyperlipidemia
Diagnosis Coronary angiography, cardiac MRI
Differential diagnosis Coronary artery spasm, thrombus
Prevention Adequate antiplatelet therapy, statins
Treatment Vasodilators, antioxidants, anti-inflammatory drugs
Medication N/A
Prognosis Variable, depends on extent of microvascular damage
Frequency Occurs in 2-5% of percutaneous coronary intervention cases
Deaths N/A


No Reflow Phenomenon[edit | edit source]

The no reflow phenomenon is a medical condition that occurs when there is an inadequate blood flow to a region of the heart muscle after the reopening of a blocked coronary artery. This phenomenon is often observed after procedures such as percutaneous coronary intervention (PCI) or thrombolysis in patients with acute myocardial infarction.

Pathophysiology[edit | edit source]

The no reflow phenomenon is characterized by the inability of blood to adequately perfuse the microvasculature despite the successful removal of a blockage in a larger vessel. This can be due to several factors, including microvascular damage, endothelial dysfunction, and the presence of microemboli. The condition can lead to further myocardial damage and is associated with worse clinical outcomes.

Causes[edit | edit source]

Several mechanisms have been proposed to explain the no reflow phenomenon:

  • Microvascular obstruction: This occurs when small blood vessels are blocked by debris or thrombi that have broken off from the main blockage.
  • Endothelial injury: Damage to the endothelial cells lining the blood vessels can lead to impaired vasodilation and increased vascular resistance.
  • Inflammation: Inflammatory processes can exacerbate microvascular dysfunction and contribute to no reflow.
  • Reperfusion injury: The restoration of blood flow can itself cause damage to the microvasculature, leading to no reflow.

Clinical Implications[edit | edit source]

The presence of the no reflow phenomenon is associated with a higher risk of adverse outcomes, including increased mortality, larger infarct size, and reduced left ventricular function. It is important for clinicians to recognize and address this condition to improve patient outcomes.

Management[edit | edit source]

Management strategies for the no reflow phenomenon include pharmacological and mechanical interventions:

Related Pages[edit | edit source]

Cardiovascular disease A-Z

Most common cardiac diseases

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