Updates in the Definition, Diagnostic Work Up, and Therapeutic Strategies for MINOCA

AbstractPurpose of reviewMyocardial infarction with non-obstructive coronary arteries (MINOCA) is found in up to 6% of patients presenting with acute coronary syndrome. These patients represent a group with unique pathophysiology and treatment needs. This review summarizes recent advancement in the understanding of the causes and diagnostic work up of patients presenting with MINOCA.Recent findingsHistorically the importance of MINOCA has been under-recognized, and the condition was considered a more benign form of acute coronary syndrome. More recently consensus documents from major cardiac societies have highlighted the unique aspects of MINOCA in terms of etiology, diagnosis, and management. Central to this is the understanding that MINOCA should be considered a working diagnosis and prompt detailed investigation into the underlying pathophysiological cause and, where available, the institution of guideline-based medical therapies.SummaryThe diagnosis of MINOCA is increasingly being recognized as important both because it identifies a group of patients who differ clinically from those with obstructive coronary artery disease and because it necessitates further diagnostic work up. MINOCA is associated with excess morbidity and mortality, and there is a paucity of data to guide treatment strategies in this heterogeneous group of patients. Further work allows more accurate understanding of risks and optimal management in this population.
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research