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非阻塞性冠状动脉所致心肌梗死:当前的管理策略

Myocardial infarction with nonobstructive coronary arteries: Current management strategies.

作者信息

Buda Kevin G, Mallick Sanjoyita, Kohl Louis P

机构信息

Cardiology Division, Department of Internal Medicine, Hennepin Healthcare, Minneapolis, MN; Minneapolis Heart Institute and Abbott Northwestern Hospital, Minneapolis, MN.

Department of Medicine, Hennepin Healthcare, Minneapolis, MN

出版信息

Cleve Clin J Med. 2024 Dec 2;91(12):743-753. doi: 10.3949/ccjm.91a.19127.

Abstract

From 6% to 8% of patients who present with myocardial infarction have no evidence of obstructive coronary artery disease on angiography. This subgroup tends to be younger, and more of them are women. This review highlights a proposed algorithm to identify the underlying cause of myocardial infarction with nonobstructive coronary arteries (MINOCA). We emphasize the need for a collaborative approach in diagnosing and managing MINOCA to improve patient outcomes, advocating for a standardized diagnostic pathway that incorporates cardiac magnetic resonance imaging and comprehensive clinical evaluation to tailor treatments effectively.

摘要

在因心肌梗死就诊的患者中,有6%至8%的人在血管造影检查中没有阻塞性冠状动脉疾病的证据。这一亚组患者往往较为年轻,女性比例更高。本综述重点介绍了一种用于识别非阻塞性冠状动脉心肌梗死(MINOCA)潜在病因的建议算法。我们强调在诊断和管理MINOCA时需要采取协作方法以改善患者预后,主张采用标准化诊断途径,纳入心脏磁共振成像和全面临床评估,以便有效制定治疗方案。

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