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Updated: Jun 29, 2025
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
[MINOCA and Coronary Ectasia: a rare combination of causes of infarction]
Juan Pablo Ricarte-Bratti1, Julio Oscar Emilio Bono2, Matias Morsone3
1Universidad Nacional de Córdoba. jpricartebratti@gmail.com.
Insights
This case highlights myocardial infarction with non-obstructive arteries (MINOCA) in a patient with coronary ectasias. Further research is needed to understand this association and non-ischemic causes of MINOCA.
Area of Science:
- Cardiology
- Internal Medicine
Context:
- Presents a clinical case of a 58-year-old male with a history of hypertension, dyslipidemia, COPD, and prior myocardial infarction.
- Patient presented with chest pain and dyspnea, indicative of acute cardiac distress.
Purpose:
- To describe a patient with myocardial ischemia stemming from multiple underlying causes.
- To highlight the diagnostic challenges and management of Myocardial Infarction with Non-Obstructive Arteries (MINOCA).
Summary:
- The patient experienced tachyarrhythmia and hemodynamic deterioration, diagnosed with Non-ST segment elevation acute coronary syndrome (NSTEACS), ventricular arrhythmia, and acute pulmonary edema.
- Coronary angiography revealed coronary ectasias without obstructive lesions, leading to a diagnosis of MINOCA.
- Successful treatment involved non-invasive ventilation, diuretics, vasodilators, and anticoagulation.
Impact:
- Emphasizes the importance of considering non-ischemic etiologies in MINOCA cases.
- Underscores the association between coronary ectasia and adverse cardiovascular events, necessitating further investigation.
Objective:
to describe a patient with myocardial ischemia with multiple causes.
Clinical Case:
This clinical case describes a 58-year-old man with a history of hypertension, dyslipidemia, COPD and previous myocardial infarction (AMI). He went to the emergency room with chest pain and dyspnea. Findings included bibasal crackles, electrocardiogram with old anterior fibrosis, elevated NT-ProBNP, and echocardiogram with septoapical akinesia. During hospitalization, he experienced tachyarrhythmia and hemodynamic deterioration, undergoing electrical cardioversion (CVE). Non-ST segment elevation acute coronary syndrome (NSTEACS) complicated with ventricular arrhythmia and acute pulmonary edema was diagnosed. Coronary angiography revealed coronary ectasias without obstructive lesions, but with mild stenosis in three vessels. The patient was successfully treated with non-invasive ventilation, diuretics, vasodilators and anticoagulation. The discharge was granted with the plan to further studies to optimize and guide treatment and finally the diagnosis of Myocardial Infarction with Non-Obstructive Arteries (MINOCA) and the presence of coronary ectasias was addressed.
Conclusion:
it is important to highlight the non-ischemic causes in MINOCA and the association between coronary ectasia and cardiovascular events, which is why we emphasize the need for more studies to better understand the relationship between these phenomena.
