Diagnostic pathways in myocardial infarction with non-obstructive coronary artery disease (MINOCA)

被引:60
作者
Occhipinti, Giovanni [1 ]
Bucciarelli-Ducci, Chiara [2 ,3 ]
Capodanno, Davide [1 ]
机构
[1] Univ Catania, Azienda Osped Univ Policlin G Rodolico San Marco, Div Cardiol, Via S Sofia 78, I-95123 Catania, Italy
[2] Univ Hosp Bristol NHS Trust, Biomed Res Ctr, Bristol Natl Inst Hlth Res NIHR, Bristol Heart Inst, Terrell St, Bristol BS2 8ED, Avon, England
[3] Univ Bristol, Terrell St, Bristol BS2 8ED, Avon, England
关键词
MINOCA; Myocardial injury; Myocardial ischaemia; Non-obstructive coronary arteries; ST-SEGMENT ELEVATION; CARDIOVASCULAR MAGNETIC-RESONANCE; SUPPRESS ADVERSE OUTCOMES; RAPID RISK STRATIFICATION; SYNDROME TAKO-TSUBO; EARLY IMPLEMENTATION; TAKOTSUBO SYNDROME; EUROPEAN-SOCIETY; WORKING GROUP; GUIDELINES;
D O I
10.1093/ehjacc/zuab049
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
When acute myocardial injury is found in a clinical setting suggestive of myocardial ischaemia, the event is labelled as acute myocardial infarction (AMI), and the absence of coronary stenosis angiographically 50% or greater leads to the working diagnosis of myocardial infarction with non-obstructive coronary arteries (MINOCA). The initial diagnosis of MINOCA can be confirmed or ruled out based on the results of subsequent investigations. This narrative review discusses the downstream diagnostic approaches to MINOCA, and appraises strengths and limitations of invasive and non-invasive investigations for this condition. The aim of this article is to increase the awareness that establishing the underlying cause of a MINOCA is possible in the vast majority cases. Determining the cause of MINOCA and excluding other possible causes for cardiac troponin elevation has notable implications for tailoring secondary prevention measures aimed at improving the overall prognosis of AMI. [GRAPHICS]
引用
收藏
页码:813 / 822
页数:10
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