Bakhshi Hooman, Gibson C Michael
Division of Cardiology, Department of Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Am Heart J Plus. 2023 Jul 29;33:100312. doi: 10.1016/j.ahjo.2023.100312. eCollection 2023 Sep.
Myocardial infarction without obstructive coronary artery disease (MINOCA) is defined as myocardial infarction with mild or no obstructive coronary artery disease (CAD) on angiogram. MINOCA has a number of heterogeneous causes, including coronary disruption, coronary vasospasm, coronary embolism, spontaneous coronary artery dissection (SCAD), and coronary microvascular dysfunction (CMD). Even though MINOCA might have a better prognosis than MI with obstructive CAD, it is not benign. A stepwise diagnostic approach is crucial to identifying the underlying cause of MINOCA or conditions mimicking it. A cause-specific treatment approach is the key to managing MINOCA.
非阻塞性冠状动脉疾病所致心肌梗死(MINOCA)被定义为血管造影显示冠状动脉疾病(CAD)轻度或无阻塞的心肌梗死。MINOCA有多种不同病因,包括冠状动脉破裂、冠状动脉痉挛、冠状动脉栓塞、自发性冠状动脉夹层(SCAD)和冠状动脉微血管功能障碍(CMD)。尽管MINOCA的预后可能比阻塞性CAD所致心肌梗死更好,但它并非良性疾病。逐步诊断方法对于识别MINOCA的潜在病因或类似疾病至关重要。针对病因的治疗方法是管理MINOCA的关键。