The Imaging Toolbox to Assess Patients with Suspected Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease (MINOCA)

Talebi, Soheila; Moreno, Pedro R.; Dominguez, Abel Casso; Tamis‐Holland, Jacqueline E.

doi:10.1007/s11886-020-01379-x

Cited by 8 publications

(15 citation statements)

References 22 publications

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“…Current guidelines recommend medical treatment of plaque rupture with MINOCA in a similar manner to plaque rupture with obstructive coronary artery diseaese [ 9 ]. Therefore, for patients with confirmed plaque disruption and MINOCA, dual antiplatelet therapy can be prescribed for 1 year followed by lifetime single antiplatelet therapy.…”

Section: A Review Of Minoca Etiologiesmentioning

confidence: 99%

“…To define the underlying cause, scientific statements and guidelines recommend multimodality imaging in MINOCA [ 2 ••, 7 , 8 ]. A recent review [ 9 ] highlights the importance of such imaging to uncover all cases of MINOCA. In the current paper, we review the major coronary etiologies of MINOCA, highlight newer data supporting multimodality imaging in patients with suspected MINOCA, and provide some case examples.…”

Section: Introductionmentioning

confidence: 99%

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Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease (MINOCA): a Review of the Present and Preview of the Future

Talebi

Jadhav

Tamis‐Holland

2021

Curr Atheroscler Rep

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Purpose of Review The syndrome of myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) is not uncommon and has multiple potential coronary etiologies. With the use of more sensitive cardiac biomarkers and advanced cardiovascular imaging, MINOCA presentations have gain increasing attention among researchers and cardiologists. Despite the presence of a myocardial infarction and elevated future risk, many patients are sent home with little or no cardio-protective treatment and no explanation for their symptoms. In this review, we emphasized the importance of MINOCA treatment based on the underlying etiology. Recent Findings As there are multiple pathophysiological mechanisms potentially involved in MINOCA, it should be considered a working diagnosis until there is a better understanding regarding the underlying cause. It is critical to use multimodality imaging when treating patients with MINOCA to help determine the underlying etiology and rule out mimics of MINOCA, so that therapies appropriate to the etiology can be provided. Summary A more systematic approach to managing patients with MINOCA should result in better treatment and an improved prognosis for these patients.

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Section: A Review Of Minoca Etiologiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease (MINOCA): a Review of the Present and Preview of the Future

Talebi

Jadhav

Tamis‐Holland

2021

Curr Atheroscler Rep

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“…CMR is a particularly important diagnostic tool when MINOCA is suspected [ 53 ]. CMR has emerged as the gold standard for noninvasive assessment of the heart due to its safety, accuracy, ability to characterize the myocardium, and inter-observer consistency.…”

Section: Minoca Work-up and Clinical Treatment Regimensmentioning

confidence: 99%

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

Chow

Diep

Getman

et al. 2021

Heliyon

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“…CMRI can exclude myocarditis, nonspecific cardiomyopathies, and takotsubo cardiomyopathy. 27 Further, CMRI provides the ability to confirm imaging evidence of AMI. The presence of myocardial edema on T2-weighted imaging can identify recent MI or myocarditis.…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

“…The AHA has also emphasized on the importance of treating CAD risk factors, such as smoking, diabetes mellitus, hypertension, and hyperlipidemia to reduce risk for future events. 27 Currently, there are no randomized trials addressing the use of empiric cardioprotective medications in all patients presenting with MINOCA during the index hospitalization. Data published from the SWEDEHEART registry was the first large observational study to show benefits in utilizing secondary cardioprotective strategies such as an ACEI/ARB, statins, BB, and DAPT for the treatment of MINOCA.…”

Section: Secondary Cardioprotective Therapiesmentioning

confidence: 99%

Myocardial Infarction with Nonobstructive Coronary Artery Disease—Definition, Etiopathogenesis, Diagnosis, and Management

et al. 2021

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Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a complex clinical syndrome that is characterized by evidence of acute myocardial infarction in the absence of significant epicardial coronary artery disease on angiography. The term “MINOCA” encompasses a group of heterogeneous diseases with varying underlying mechanisms and each with its own pathophysiology. Overlooked plaque rupture or erosion and coronary vasospasm are the most common causes of MINOCA and can be diagnosed by routine intracoronary imaging and vasoreactivity testing, respectively. Coronary microvascular dysfunction is a less recognized, albeit an important cause of morbidity in patients presenting with MINOCA. Although MINOCA is a rare presentation of acute coronary syndrome, it is not a benign disorder and can have adverse consequences if untreated. In this article, we aim to review the pathogenesis, clinical characteristics, and finally propose a systematic approach in the diagnosis and management of patients with MINOCA.

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The Imaging Toolbox to Assess Patients with Suspected Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease (MINOCA)

Cited by 8 publications

References 22 publications

Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease (MINOCA): a Review of the Present and Preview of the Future

Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease (MINOCA): a Review of the Present and Preview of the Future

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

Myocardial Infarction with Nonobstructive Coronary Artery Disease—Definition, Etiopathogenesis, Diagnosis, and Management

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