Scabbia Francesca, Zerbini Michela, Pirani Lucia, Righi Riccardo, Viola Monica, Collevecchio Ada, Rizzati Roberto, Sassone Biagio
Department of Morphology, Section of Diagnostic Imaging, Surgery and Experimental Medicine, University of Ferrara, via Savonarola 9, 44121, Ferrara, Italy.
Department of Radiology, Azienda Unità Sanitaria Locale di Ferrara, via Arturo Cassoli 30, 44121, Ferrara, Italy.
BJR Case Rep. 2023 Feb 7;9(1):20220114. doi: 10.1259/bjrcr.20220114. eCollection 2023 Feb.
The acronym MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries) refers to myocardial infarction with normal or near-normal coronary arteries on invasive angiography. The broad spectrum of pathological mechanisms responsible for myocardial injury in MINOCA makes defining the exact underlying etiology challenging. We report the uncommon case of an acute myocardial infarction with normal coronary arteries suggestive of MINOCA caused by paradoxical coronary embolism due to a wide right-to-left shunting through a patent fossa ovalis. Integrated multimodality imaging diagnostic work-up, including cardiac magnetic resonance, transesophageal contrast echocardiography, and transcranial contrast Doppler, has been crucial for identifying the most likely mechanism underlying MINOCA.
首字母缩略词MINOCA（非阻塞性冠状动脉心肌梗死）指的是在有创血管造影检查中冠状动脉正常或接近正常情况下发生的心肌梗死。导致MINOCA心肌损伤的病理机制范围广泛，这使得确定确切的潜在病因具有挑战性。我们报告了一例罕见病例，该急性心肌梗死患者冠状动脉正常，提示为MINOCA，病因是通过未闭卵圆孔的广泛右向左分流导致的矛盾性冠状动脉栓塞。综合多模态成像诊断检查，包括心脏磁共振成像、经食管对比超声心动图和经颅对比多普勒超声，对于确定MINOCA最可能的潜在机制至关重要。
