Background/Aim: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is an increasingly recognized entity. Recent studies have shown that MINOCA is not a benign syndrome, with younger MINOCA patients having outcomes comparable to their myocardial infarction with obstructive coronary artery disease (MI-CAD) counterparts. In this study, we will describe the demographic, clinical and angiographic characteristics of MINOCA patients in our hospital. Methods: In this retrospective cohort study, all patients who underwent coronary angiography with the diagnosis of acute coronary syndrome during September 2016-April 2019 were screened and those with MINOCA were detected. We described the demographic, clinical, and angiographic characteristics of MINOCA patients and compared the etiologic and pathophysiological mechanisms. Results: A total of 3855 patients with acute coronary syndrome were screened and 155 were diagnosed with MINOCA, with a total prevalence of 4.02%. Among them, 48.4% were female and the overall mean age was 55.04 (13.57) years. Plaque disruption was the most common cause of MINOCA (48.4%), which was followed by microvascular dysfunction and slow flow (9.7%). We compared plaque disruption and other causes to find that age (58.31 (13.76) vs 51.89 (12.68) P=0.003), hypertension (37 (48.7%) vs 25 (31.6%) P=0.034), prior coronary artery disease history (16 (21.1%) vs 2 (2.5%) P=0.001) and creatinine clearance (67.35 (IQR: 25.8) vs 74.0 (IQR: 28.58) P=0.009) were higher in patients with plaque disruption than those without. Conclusions: MINOCA is a diagnosis of exclusion with numerous potential causes. The etiological and pathophysiological mechanisms of plaque disruption are different from other causes of MINOCA and the correct treatment approach determines the prognosis.
Aortic pseudocoarctation is a rare congenital aortic anomaly that causes
elongation, stenosis and kinking of the aorta at the isthmus level.
Although aortic coarctation and pseudocoarctation share a similar
clinical spectrum, pseudocoarctation rarely results in a significant
gradient in descending aorta and haemodynamic consequence. Therefore,
it’s critical to differentiate in coarctation. All imaging modalities
but especially cardiac CT angiography and catheterization are very
important in the differential diagnosis. Our case highlighted to
differences between aortic pseudocoarctation and coarctation, with other
cardiac anomalies accompanying pseudocoarctation. And also the
importance of cardiac imaging in the differential diagnosis of
pseudocoarctation was emphasized.
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