Myocardial infarction with nonobstructive coronary arteries: Current management strategies

Area of Science:

• Cardiology
• Cardiovascular Disease
• Medical Diagnostics

Background:

• A significant percentage of myocardial infarction (MI) cases, 6-8%, lack obstructive coronary artery disease on angiography.
• This MINOCA subgroup often presents with distinct demographic profiles, including younger age and higher prevalence in women.

Purpose of the Study:

• To present a diagnostic algorithm for identifying the causes of myocardial infarction with nonobstructive coronary arteries (MINOCA).
• To advocate for a standardized, collaborative approach to MINOCA diagnosis and management for improved patient outcomes.

Main Methods:

• Review of existing literature and proposed diagnostic strategies for MINOCA.
• Emphasis on integrating cardiac magnetic resonance imaging (CMR) into the diagnostic pathway.
• Highlighting the importance of comprehensive clinical evaluation.

Main Results:

• A proposed algorithm to systematically identify underlying causes in MINOCA patients.
• Demonstration of MINOCA's distinct patient characteristics (younger, more women).
• The review underscores the need for tailored treatment strategies based on accurate diagnosis.

Conclusions:

• A standardized diagnostic pathway is crucial for effective MINOCA management.
• Collaborative efforts between clinicians are essential to improve outcomes for MINOCA patients.
• Integrating advanced imaging like CMR can enhance diagnostic accuracy and treatment personalization.