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Updated: Jan 5, 2026

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
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Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction

Published on: August 17, 2022

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Non-ST elevation myocardial infarction, non-obstructive coronary arteries and severe regional microvascular

Thomas A Kite1, Benjamin A Marrow1, Sarah Nduwayo1

  • 1Department of Cardiovascular Sciences and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, University of Leicester, Leicester, UK.

BMJ Case Reports
|October 25, 2019
PubMed

Insights

Cardiac MRI with LGE accurately characterized myocardial infarction in MINOCA patients. This case highlights CMR

Area of Science:

  • Cardiovascular Imaging
  • Cardiology
  • Medical Diagnostics

Background:

  • Myocardial infarction with non-obstructive coronary arteries (MINOCA) diagnosis requires precise characterization of myocardial injury.
  • Cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE) is crucial for evaluating MINOCA.
  • Dilated cardiomyopathy (DCM) can present with symptoms mimicking acute myocardial infarction.

Observation:

  • A 71-year-old patient with DCM presented with acute myocardial infarction symptoms.
  • Coronary angiography confirmed MINOCA diagnosis.
  • CMR with LGE identified apical myocardial infarction.

Findings:

  • Quantitative myocardial perfusion mapping revealed reduced blood flow in non-infarcted septal segments.
  • The apical infarction's etiology is uncertain, possibly coronary plaque rupture.
  • Severe regional microvascular dysfunction was observed, a recognized but under-described phenomenon in DCM.

Implications:

  • CMR provides essential information in diagnostic uncertainty for MINOCA.
  • Microvascular dysfunction in DCM may contribute to recurrent ischemic injury and disease progression.
  • This case underscores the comprehensive diagnostic capabilities of CMR in complex cardiac scenarios.

Keywords:
heart failureischaemic heart diseaseradiologyradiology (diagnostics)

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