Division of Cardiology, Department of Medicine, Loma Linda University Health, Loma Linda, CA, USA.
Loma Linda University School of Medicine, Loma Linda, CA, USA.
Curr Cardiol Rep. 2023 Jun;25(6):561-570. doi: 10.1007/s11886-023-01874-x. Epub 2023 Apr 17.
Myocardial infarction with nonobstructive coronary arteries (MINOCA) is defined as acute myocardial infarction (MI) with angiographically no obstructive coronary artery disease or stenosis ≤ 50%. MINOCA is diagnostically challenging and complex, making it difficult to manage effectively. This condition accounts for 6-8% of all MI and poses an increased risk of morbidity and mortality after diagnosis. Prompt recognition and targeted management are essential to improve outcomes and our understanding of this condition, but this process is not yet standardized. This article offers a comprehensive review of MINOCA, delving deep into its unique clinical profile, invasive and noninvasive diagnostic strategies for evaluating MINOCA in light of the lack of widespread availability for comprehensive testing, and current evidence surrounding targeted therapies for patients with MINOCA.
MINOCA is not uncommon and requires comprehensive assessment using various imaging modalities to evaluate it further. MINOCA is a heterogenous working diagnosis that requires thoughtful approach to diagnose the underlying disease responsible for MINOCA further.
非阻塞性冠状动脉心肌梗死（MINOCA）的定义为急性心肌梗死（MI）伴有影像学无阻塞性冠状动脉疾病或狭窄 ≤ 50%。MINOCA 的诊断具有挑战性且复杂，难以有效治疗。这种情况占所有 MI 的 6-8%，并在诊断后增加了发病率和死亡率的风险。及时识别和针对性管理对于改善预后和我们对这种情况的理解至关重要，但这一过程尚未标准化。本文对 MINOCA 进行了全面综述，深入探讨了其独特的临床特征，以及在全面检查缺乏广泛可用性的情况下，用于评估 MINOCA 的有创和无创诊断策略，以及针对 MINOCA 患者的靶向治疗的现有证据。
MINOCA 并不少见，需要使用各种成像方式进行全面评估以进一步评估。MINOCA 是一个异质的工作诊断，需要深思熟虑的方法来诊断导致 MINOCA 的潜在疾病。
