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Three-Dimensional Printing of a Complex Aortic Anomaly
Published on: November 1, 2018
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[Chest pain after angiography without anomalies]
Tim Schutte1,2, Shanti Ramawadhdoebe3, Jeroen Schotten3
1Zaans Medisch Centrum, afd. Interne Geneeskunde, Longgeneeskunde en Cardiologie, Zaandam.
Nederlands Tijdschrift Voor Geneeskunde
|March 16, 2019
Summary
Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) patients face increased future heart disease risks. A case highlights coronary dissection as a potential cause in MINOCA.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Myocardial infarction is classified by ECG findings (STEMI/NSTEMI) or coronary angiography (CAG).
- Myocardial Infarction with Non-Obstructive Coronary Arteries/Atherosclerosis (MINOCA) affects up to 25% of myocardial infarction patients.
- MINOCA patients exhibit a higher risk of future cardiovascular events.
Observation:
- A 55-year-old woman experienced two myocardial infarctions within a week.
- The initial event was diagnosed as MINOCA, with normal ECG and CAG.
- The second event, five days later, presented with ST-elevations on ECG and revealed coronary dissection on CAG.
Findings:
- This case illustrates a MINOCA diagnosis followed by ST-elevation myocardial infarction due to coronary dissection.
- Coronary dissection can manifest as a cause of myocardial infarction, even in cases initially presenting as MINOCA.
Implications:
- MINOCA patients have an elevated risk for recurrent cardiac events.
- Coronary dissection should be considered in the differential diagnosis of MINOCA, particularly with recurrent symptoms.
- Further investigation into the mechanisms and management of MINOCA, including dissection, is warranted.
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