Myocardial Infarction With Non-obstructive Coronary Arteries in a Nigerian Middle-Aged Woman: A Case Report.

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a group of heterogeneous diseases with different pathological mechanisms. It is often under-recognized because of its diverse differential diagnoses like myocarditis, takotsubo cardiomyopathy, spontaneous coronary artery dissection (SCAD), coronary microvascular dysfunction, vasospasm, coronary erosion, and embolism. Evaluation with multimodality imaging including intravascular coronary imaging and cardiac magnetic resonance is often necessary to determine the underlying etiology and management. We report a case of MINOCA in Nigeria involving a 55-year-old woman with metabolic syndrome who experienced cardiac arrest following an intra-abdominal procedure with an electrocardiogram (ECG) and biomarkers consistent with myocardial injury but had non-obstructive coronary artery disease (CAD) on angiography. This case underscores the need to consider MINOCA in patients presenting with myocardial infarction and non-obstructive coronary angiogram, particularly those with multiple comorbidities, and the need for a comprehensive diagnostic approach to uncover the underlying mechanism. Our report encourages increased clinical index of suspicion of this condition while contributing to the growing body of knowledge of this underdiagnosed clinical entity.