Darragh Brady, MD; John Duignan, MB BCh, BAO, MRCPI; Jonathan D. Dodd, MD, MSc, MRCPI, FFR(RCSI)
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
Myocardial infarction (MI) unrelated to coronary atherosclerosis
Typically (though not always), there are no obstructed epicardial coronary arteries, so-called "MINOCA"
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Echocardiographic Findings
Angiographic Findings
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Ibanez B et al: 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 39(2):119-77, 2018
Manolis AS et al: Acute coronary syndromes in patients with angiographically normal or near normal (non-obstructive) coronary arteries. Trends Cardiovasc Med. ePub, 2018
Joseph L et al: Non-atherosclerotic vascular disease in women. Curr Treat Options Cardiovasc Med. 19(10):78, 2017
Mihatov N et al: Type 2 myocardial infarction due to supply-demand mismatch. Trends Cardiovasc Med. 27(6):408-417, 2017
Pathik B et al: Troponin-positive chest pain with unobstructed coronary arteries: incremental diagnostic value of cardiovascular magnetic resonance imaging. Eur Heart J Cardiovasc Imaging. 17(10):1146-52, 2016
Pasupathy S et al: Myocardial infarction with non-obstructive coronary arteries - diagnosis and management. Eur Cardiol. 10(2):79-82, 2015
Silvanto A et al: Myocardial infarction with normal coronaries: an autopsy perspective. J Clin Pathol. 65(6):512-6, 2012
Yurtdaş M et al: A case of coronary spasm with resultant acute myocardial infarction: likely the result of an allergic reaction. Intern Med. 51(16):2161-4, 2012
Kim JA et al: Less common causes of disease involving the coronary arteries: MDCT findings. AJR Am J Roentgenol. 197(1):125-30, 2011
Leurent G et al: Diagnostic contributions of cardiac magnetic resonance imaging in patients presenting with elevated troponin, acute chest pain syndrome and unobstructed coronary arteries. Arch Cardiovasc Dis. 104(3):161-70, 2011
Budoff MJ et al: Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY trial. J Am Coll Cardiol. 52(21):1724-32, 2008
Kardasz I et al: Myocardial infarction with normal coronary arteries: a conundrum with multiple aetiologies and variable prognosis: an update. J Intern Med. 261(4):330-48, 2007
Larsen AI et al: Characteristics and outcomes of patients with acute myocardial infarction and angiographically normal coronary arteries. Am J Cardiol. 95(2):261-3, 2005
Villines TC et al: Diffuse nonatherosclerotic coronary aneurysms: an unusual cause of sudden death in a young male and a literature review. Cardiol Rev. 13(6):309-11, 2005
Caussin C et al: Coronary plaque burden detected by multislice computed tomography after acute myocardial infarction with near-normal coronary arteries by angiography. Am J Cardiol. 92(7):849-52, 2003
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
TERMINOLOGY
Definitions
Myocardial infarction (MI) unrelated to coronary atherosclerosis
Typically (though not always), there are no obstructed epicardial coronary arteries, so-called "MINOCA"
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Echocardiographic Findings
Angiographic Findings
Nuclear Medicine Findings
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Ibanez B et al: 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 39(2):119-77, 2018
Manolis AS et al: Acute coronary syndromes in patients with angiographically normal or near normal (non-obstructive) coronary arteries. Trends Cardiovasc Med. ePub, 2018
Joseph L et al: Non-atherosclerotic vascular disease in women. Curr Treat Options Cardiovasc Med. 19(10):78, 2017
Mihatov N et al: Type 2 myocardial infarction due to supply-demand mismatch. Trends Cardiovasc Med. 27(6):408-417, 2017
Pathik B et al: Troponin-positive chest pain with unobstructed coronary arteries: incremental diagnostic value of cardiovascular magnetic resonance imaging. Eur Heart J Cardiovasc Imaging. 17(10):1146-52, 2016
Pasupathy S et al: Myocardial infarction with non-obstructive coronary arteries - diagnosis and management. Eur Cardiol. 10(2):79-82, 2015
Silvanto A et al: Myocardial infarction with normal coronaries: an autopsy perspective. J Clin Pathol. 65(6):512-6, 2012
Yurtdaş M et al: A case of coronary spasm with resultant acute myocardial infarction: likely the result of an allergic reaction. Intern Med. 51(16):2161-4, 2012
Kim JA et al: Less common causes of disease involving the coronary arteries: MDCT findings. AJR Am J Roentgenol. 197(1):125-30, 2011
Leurent G et al: Diagnostic contributions of cardiac magnetic resonance imaging in patients presenting with elevated troponin, acute chest pain syndrome and unobstructed coronary arteries. Arch Cardiovasc Dis. 104(3):161-70, 2011
Budoff MJ et al: Diagnostic performance of 64-multidetector row coronary computed tomographic angiography for evaluation of coronary artery stenosis in individuals without known coronary artery disease: results from the prospective multicenter ACCURACY trial. J Am Coll Cardiol. 52(21):1724-32, 2008
Kardasz I et al: Myocardial infarction with normal coronary arteries: a conundrum with multiple aetiologies and variable prognosis: an update. J Intern Med. 261(4):330-48, 2007
Larsen AI et al: Characteristics and outcomes of patients with acute myocardial infarction and angiographically normal coronary arteries. Am J Cardiol. 95(2):261-3, 2005
Villines TC et al: Diffuse nonatherosclerotic coronary aneurysms: an unusual cause of sudden death in a young male and a literature review. Cardiol Rev. 13(6):309-11, 2005
Caussin C et al: Coronary plaque burden detected by multislice computed tomography after acute myocardial infarction with near-normal coronary arteries by angiography. Am J Cardiol. 92(7):849-52, 2003
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