Clinical presentation and management of myocardial infarction with nonobstructive coronary arteries (MINOCA): A literature review

Erica Chow; Brian Diep; Tatiana Getman; Amir Kilani; Bashar Khiatah; Sam Jazayeri; Craig Mansour

doi:10.1016/j.heliyon.2021.e08362

Clinical presentation and management of myocardial infarction with nonobstructive coronary arteries (MINOCA): A literature review

Heliyon. 2021 Nov 11;7(11):e08362. doi: 10.1016/j.heliyon.2021.e08362. eCollection 2021 Nov.

Authors

Erica Chow^{1

2}, Brian Diep^{1

2}, Tatiana Getman^{1

2}, Amir Kilani^{1

2}, Bashar Khiatah³, Sam Jazayeri³, Craig Mansour⁴

Affiliations

¹ Western University of Health Sciences, Pomona, CA 91766, USA.
² Community Memorial Hospital, 147 N Brent St, Ventura CA 93003, USA.
³ Department of Internal Medicine, Community Memorial Hospital, 147 N Brent St, Ventura CA 93003, USA.
⁴ Cardiology Associates Medical Group, 168 North Brent Street Suite 503, Ventura, CA 93003, USA.

Abstract

Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA), as the name implies, is an acute myocardial infarction (MI) in the absence of significant coronary artery obstruction. Diagnosis and management of such cases have been challenging. There are many etiologies of MINOCA including coronary artery spasm, coronary microvascular dysfunction, plaque disruption, spontaneous coronary thrombosis or emboli, spontaneous coronary artery dissection, or cardiomyopathies. In this paper, the pathophysiology, diagnostic work-up, and clinical management for each subtype are described, and an overarching approach on how to evaluate and manage a patient presenting with MINOCA.

Keywords: Coronary artery spasm; Coronary plaque disruption; MINOCA; Pathophysiology.

Publication types

Review