Myocardial Infarction Without Obstructive Coronary Artery Disease (MINOCA): A Practical Guide for Clinicians
Myocardial infarction without obstructive coronary artery disease (MINOCA) is defined by the evidence of spontaneous acute myocardial infarction (MI) and angiographic exclusion of coronary stenoses ≥50% in any potential infarct related artery, after having ruled out other clinically overt causes for...
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| Published in | Current problems in cardiology Vol. 46; no. 3; p. 100761 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.03.2021
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| Online Access | Get full text |
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| Abstract | Myocardial infarction without obstructive coronary artery disease (MINOCA) is defined by the evidence of spontaneous acute myocardial infarction (MI) and angiographic exclusion of coronary stenoses ≥50% in any potential infarct related artery, after having ruled out other clinically overt causes for the acute presentation. The introduction of this new concept was meant to encourage discovery of putative pathophysiological mechanisms and development of specific therapeutic measures. In recent years, we have witnessed significant advances in the fields of epidemiology, pathophysiology, diagnosis, prognosis estimation and therapeutics of MINOCA. So far, however, the definition of MINOCA has been rather heterogeneous since specific cardiac conditions such as myocarditis and Takotsubo syndrome have often been included, generating conflicting results. In this review, we summarize the current state-of-the-art in the expanding MINOCA field and propose a comprehensive stepwise approach for the rational diagnostic assessment of these challenging patients. Our aim is to provide clinicians with an “Ariadne's thread” according to the recent fourth universal definition of MI in order to not get lost in MINOCA's labyrinth. |
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| AbstractList | Myocardial infarction without obstructive coronary artery disease (MINOCA) is defined by the evidence of spontaneous acute myocardial infarction (MI) and angiographic exclusion of coronary stenoses ≥50% in any potential infarct related artery, after having ruled out other clinically overt causes for the acute presentation. The introduction of this new concept was meant to encourage discovery of putative pathophysiological mechanisms and development of specific therapeutic measures. In recent years, we have witnessed significant advances in the fields of epidemiology, pathophysiology, diagnosis, prognosis estimation and therapeutics of MINOCA. So far, however, the definition of MINOCA has been rather heterogeneous since specific cardiac conditions such as myocarditis and Takotsubo syndrome have often been included, generating conflicting results. In this review, we summarize the current state-of-the-art in the expanding MINOCA field and propose a comprehensive stepwise approach for the rational diagnostic assessment of these challenging patients. Our aim is to provide clinicians with an “Ariadne's thread” according to the recent fourth universal definition of MI in order to not get lost in MINOCA's labyrinth. |
| ArticleNumber | 100761 |
| Author | Dello Russo, Antonio Compagnucci, Paolo Guerra, Federico Stronati, Giulia Ciliberti, Giuseppe Lattanzi, Simona Bianco, Francesco Urbinati, Alessia |
| Author_xml | – sequence: 1 givenname: Giuseppe surname: Ciliberti fullname: Ciliberti, Giuseppe organization: Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital “Umberto I – Lancisi – Salesi,” Ancona, Italy – sequence: 2 givenname: Paolo surname: Compagnucci fullname: Compagnucci, Paolo organization: Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital “Umberto I – Lancisi – Salesi,” Ancona, Italy – sequence: 3 givenname: Alessia surname: Urbinati fullname: Urbinati, Alessia organization: Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital “Umberto I – Lancisi – Salesi,” Ancona, Italy – sequence: 4 givenname: Francesco surname: Bianco fullname: Bianco, Francesco organization: Department of Neuroscience, Imaging and clinical Sciences, “G. d'Annunzio” University, Chieti, Italy – sequence: 5 givenname: Giulia surname: Stronati fullname: Stronati, Giulia organization: Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital “Umberto I – Lancisi – Salesi,” Ancona, Italy – sequence: 6 givenname: Simona surname: Lattanzi fullname: Lattanzi, Simona organization: Neurology Clinic, Marche Polytechnic University, Ancona, Italy – sequence: 7 givenname: Antonio surname: Dello Russo fullname: Dello Russo, Antonio organization: Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital “Umberto I – Lancisi – Salesi,” Ancona, Italy – sequence: 8 givenname: Federico surname: Guerra fullname: Guerra, Federico email: f.guerra@univpm.it organization: Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital “Umberto I – Lancisi – Salesi,” Ancona, Italy |
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