Myocardial Infarction With Non-obstructive Coronary Arteries (MINOCA) in a High-Risk Young Man: A Case Report
Oumama Soussi1, Houda Bachri1, Nesma Bendagha1
1Cardiology, Ibn Sina Hospital, Ibn Sina University Hospital Center, Mohammed V University, Rabat, MAR.
Cureus
|July 10, 2025
Summary
Myocardial infarction with non-obstructive coronary arteries (MINOCA) in young adults poses diagnostic challenges. Advanced imaging is crucial for confirming MINOCA and guiding treatment in these complex acute coronary syndrome cases.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Acute coronary syndrome (ACS) in young adults often presents diagnostic challenges, particularly when coronary angiography reveals no obstructive lesions.
- Myocardial infarction with non-obstructive coronary arteries (MINOCA) requires differentiation from other causes of ischemic and non-ischemic chest pain.
Observation:
- A 27-year-old male with multiple cardiovascular risk factors presented with chest pain and ECG changes mimicking ST-segment elevation myocardial infarction (STEMI).
- Initial fibrinolysis was administered due to the STEMI-like presentation, but persistent symptoms suggested MINOCA.
- Coronary angiography showed no obstructive lesions, while cardiac MRI confirmed an apical transmural myocardial infarction.
Findings:
- The case highlights the diagnostic complexity of MINOCA in young adults with ACS.
- Advanced imaging, such as cardiac MRI, is essential for accurate diagnosis of MINOCA.
- Standard medical therapy for myocardial infarction was initiated, with anti-anginal agents added for recurrent angina.
Implications:
- This case underscores the importance of considering MINOCA in young adults presenting with ACS, even with significant cardiovascular risk factors.
- Further research is needed on optimal acute management strategies for MINOCA, including the role of fibrinolysis versus conservative approaches.
- Intracoronary imaging techniques like intravascular ultrasound (IVUS) and optical coherence tomography (OCT) may play a future role in MINOCA diagnosis and management.
Keywords:
acute coronary syndrome (acs)cardiovascular risk factors (cvrf)myocardial infarction with non-obstructive coronary arteries (minocas)non-obstructive coronary diseaseyoung adultsMore Related Videos
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