Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, 1111 Avenue New York, Amsterdam, NY, 10025, USA.
Curr Atheroscler Rep. 2021 Jul 6;23(9):49. doi: 10.1007/s11883-021-00945-0.
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.
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. A more systematic approach to managing patients with MINOCA should result in better treatment and an improved prognosis for these patients.
非阻塞性冠状动脉疾病（MINOCA）相关心肌梗死综合征并不少见，且有多种潜在的冠状动脉病因。随着更敏感的心脏生物标志物和先进的心血管成像技术的应用，MINOCA 表现越来越受到研究人员和心脏病专家的关注。尽管存在心肌梗死和未来风险增加，但许多患者被送回家，几乎没有或没有给予心脏保护治疗，也没有对其症状做出解释。在这篇综述中，我们强调了根据潜在病因进行 MINOCA 治疗的重要性。
由于 MINOCA 可能涉及多种病理生理机制，因此在更好地了解潜在病因之前，应将其视为一个待处理的诊断。在治疗 MINOCA 患者时，使用多模态成像非常重要，有助于确定潜在病因并排除 MINOCA 的类似物，以便提供针对病因的治疗方法。更系统地管理 MINOCA 患者应能改善这些患者的治疗效果和预后。
