Acute ST elevation myocardial infarction with angiographically normal coronary arteries: Causes and outcomes

Acute myocardial infarction with normal coronary artery (MINCA) in a patient with multiple sclerosis

“…Long-term outcomes appear favourable in the majority of patients [1]. It was reported that there was no recurrence of anginal symptoms in any of the MINCA patients and no patient underwent a revascularization procedure within 1 year [1,3].…”

“…Also, myocarditis is one of the possible causes of MINCA, especially in patients below the age of 35 years [11]. Other potential mechanisms are cocaine ingestion, coagulopathies (inherited or acquired), stress cardiomyopathy or Takotsubo syndrome, myocardial bridging and spontaneous coronary artery dissection [1,12,13].…”

“…The existence of acute myocardial infarction despite angiographically normal coronary arteries (MINCA) was recognized for more than 30 years and its incidence varied between 1.0% and 8.5% [1][2][3][4][5]. The aetiology and pathogenesis of the condition are still a source of debate.…”

The Role of Coronary Computed Tomography Angiography and Cardiac Magnetic Resonance in STEMI Patients with Normal Coronary Angiography

“…The rest (68%) were considered to have a cryptogenic cause. 6 Pasupathy et al conducted a study in which they found a one-year mortality rate of 4.7% in patients with STEMI and normal coronary angiography. 7 Another study by DaCosta et al revealed that other causes of MI with normal coronary arteries (MINOCA) may include vascular spasm, microvascular dysfunction, and thrombophilic states.…”

“…For example, the diagnosis of a non-ischemic etiology may not require antiplatelet therapies. 6 CMR is a very useful tool in highlighting the myocardial edema or inflammation and in diagnosing acute myocarditis. 10 The most accurate and validated function of CMR for the diagnosis of MI is delayed enhancement CMR (DE-CMR), which can measure the infarction size in association with the levels of serum cardiac enzymes.…”