Cardiology Letters 2022, 31(4):249-254

MINOCA: myocardial infarction without coronary artery obstruction - case report and review of literature

Snopek P^{1, 2}, Hasilla J^{1, 3}, Patrovič L⁴, Juskanič D⁴, Benko J⁵, Samoš M⁵

¹ Kardiologická klinika FN Nitra

² Vysoká škola zdravotníctva a sociálnej práce Sv. Alžbety, n. o.

³ Univerzita Konštantína Filozofa Nitra

⁴ Jessenius diagnostické centrum s.r.o. Nitra

I. interná klinika, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Slovenská republika

The definition of myocardial infarction without coronary artery obstruction (MINOCA) is found in the fourth Universal Definition of Myocardial Infarction. The main point of diagnosis is the negative finding of hemodynamically significant stenosis of coronary arteries. From an etiological point of view, the cause of MINOCA can be coronary, myocardial, or non-cardiac. In terms of functional status, as well as mortality, there is no significant difference between MINOCA and myocardial infarction with coronary artery obstruction. We present a review and a case report describing this topic. The patient was admitted for acute coronary syndrome without persistent ST elevations on ECG. The echocardiography proved no regional wall motion abnormalities of the left ventricle. There were no stenoses of coronary arteries on the coronary angiography. Finally, cardiac MRI proved a small area of late gadolinium enhancement which corresponded with an ischemic scar on the inferior wall of the left ventricle.

Keywords: acute coronary syndrome; thromboembolism; vasospasm; microvascular dysfunction

Published: April 1, 2022  Show citation