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The Myth of Myocardial Infarction With Normal Coronary Angiography

Ziad A Taher1,2, Abdulhalim J Kinsara3

  • 1Department of Medicine, King Abdullah International Medical Research Center, Jeddah, SAU.

Cureus
|April 7, 2021
PubMed

Insights

Myocardial infarction with no obstructive coronary artery disease, a type of acute coronary syndrome, presents like a heart attack but without significant blockages. Understanding its varied causes is key to effective treatment strategies.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Vascular Biology

Background:

  • Myocardial infarction with no obstructive atherosclerosis (MINOCA) is a growing clinical concern within acute coronary syndromes (ACS).
  • MINOCA shares clinical symptoms with obstructive ACS but lacks significant coronary artery disease on angiography.
  • The underlying pathophysiology of MINOCA remains incompletely understood, leading to diverse clinical presentations.

Purpose of the Study:

  • To review the current knowledge on MINOCA.
  • To discuss the postulated pathophysiological mechanisms.
  • To present updated management strategies for MINOCA.

Main Methods:

  • Literature review of existing studies on MINOCA.
  • Analysis of postulated pathophysiological mechanisms.
  • Synthesis of current evidence for management.

Main Results:

  • MINOCA is increasingly recognized, presenting with ACS symptoms but non-obstructive coronary arteries.
  • Multiple mechanisms are proposed, but a definitive cause is not established.
  • Treatment approaches are varied, contingent on the suspected underlying mechanism.

Conclusions:

  • MINOCA represents a significant diagnostic and therapeutic challenge in cardiology.
  • Further research is needed to elucidate definitive pathophysiological pathways.
  • Tailored management strategies based on probable mechanisms are essential for optimal patient outcomes.

Keywords:
acute coronary syndromemyocardial infarction of no obstructive atherosclerosispathophysiology

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