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Juan Pablo Ricarte-Bratti1, Julio Oscar Emilio Bono2, Raul Barcudi3

  • 1Universidad Nacional de Córdoba. jpricartebratti@gmail.com.

Revista De La Facultad De Ciencias Medicas (Cordoba, Argentina)
|July 4, 2023
PubMed
Summary

Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) is a syndrome encompassing various pathologies within acute coronary syndrome. This review updates MINOCA definitions, excluding myocarditis and Takotsubo syndrome, and details management strategies based on advanced imaging.

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Area of Science:

  • Cardiology
  • Internal Medicine

Context:

  • Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) is a clinical syndrome occurring in the context of acute coronary syndrome.
  • MINOCA's incidence and definition vary based on diagnostic methods and the inclusion/exclusion of conditions like myocarditis and Takotsubo syndrome.

Purpose:

  • To provide a concise update on the syndrome of MINOCA, specifically highlighting the recent exclusion of myocarditis and Takotsubo syndrome from its definition.
  • To review the diagnostic approaches and management strategies for the three main types of MINOCA.

Summary:

  • This review focuses on MINOCA, excluding myocarditis and Takotsubo syndrome, to offer a current perspective.
  • Diagnosis relies heavily on specific complementary imaging techniques due to limitations of coronary angiography.

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  • Management is primarily pharmacological, tailored to the underlying pathophysiological mechanism of each MINOCA type.

    • Impact:

    • Offers a clarified understanding of MINOCA by excluding specific conditions, aiding in more precise diagnosis.
    • Emphasizes the importance of advanced imaging for accurate MINOCA diagnosis.
    • Provides updated guidance on pharmacological management strategies for MINOCA based on its diverse etiologies.