[Myocardial infarction with nonobstructive coronary arteries]

Area of Science:

• Cardiology
• Cardiovascular Research
• Medical Diagnostics

Background:

• Myocardial infarction with non-obstructive coronary arteries (MINOCA) is an emerging clinical issue.
• MINOCA represents approximately 6% of all myocardial infarction (MI) cases.
• MINOCA can serve as both a working and final diagnosis, necessitating etiological clarification.

Purpose of the Study:

• To review the diagnostic approaches and potential causes of MINOCA.
• To highlight the importance of differentiating MINOCA from other myocardial injuries.
• To discuss the current limitations in established treatment guidelines for MINOCA.

Main Methods:

• Review of current literature on MINOCA.
• Diagnostic criteria based on the Fourth Universal Definition of MI.
• Utilizing advanced imaging techniques like cardiac MRI, optical coherence tomography (OCT), and intravascular ultrasound for etiological investigation.

Main Results:

• Common causes of MINOCA include vasospasm, coronary artery embolism, spontaneous coronary artery dissection, and plaque rupture.
• Cardiac MRI is vital for distinguishing MI from non-ischemic myocardial injury.
• Intravascular visualization methods like OCT and intravascular ultrasound aid in detailed diagnosis.

Conclusions:

• Accurate diagnosis of MINOCA requires verification of MI and specific etiological studies.
• Treatment strategies and patient prognosis are highly dependent on the underlying cause of MINOCA.
• Further research is needed to establish standardized treatment guidelines for MINOCA.