A Multimodality Imaging Approach for Diagnosis of Myocardial Infarction with Nonobstructive Coronary Arteries

Myocardial infarction with nonobstructive coronary arteries (MINOCA) refers to a clinical syndrome where a patient meets the criteria for acute MI, but coronary angiography shows no obstructive coronary artery disease. MINOCA accounts for 6% to 8% of all myocardial infarctions and is more common in non-ST-elevation MI than ST-elevation MI. Up to 60% of cases of MINOCA are seen in women, which disproportionately affects younger and middle-aged women. Patients are typically younger than those with obstructive MI and have fewer traditional risk factors. Formal recognition aids the development of targeted research, standardized care, and improved outcomes.