Summary
This 2023 narrative review in the Journal of Cardiology synthesises current understanding of myocardial infarction occurring without obstructive coronary disease (MINOCA), a condition of increasing clinical recognition. The authors describe the heterogeneous pathophysiological mechanisms underlying MINOCA—including coronary vasospasm, thromboembolism, and microvascular dysfunction—and outline diagnostic pathways to distinguish this syndrome from obstructive myocardial infarction. The paper appears to position accurate diagnosis and mechanistic characterisation as essential for appropriate clinical management of this patient population.
Regional applicability
As a clinical cardiology review, the diagnostic and pathophysiological framework presented is applicable to UK cardiac care settings and may inform NHS clinical practice for assessment of patients presenting with acute coronary syndromes without angiographically evident obstruction. However, the paper does not address UK-specific epidemiological or healthcare system factors.
Key measures
Diagnostic criteria, pathophysiological mechanisms, clinical outcomes in myocardial infarction with non-obstructive coronary arteries (MINOCA)
Outcomes reported
The study examined the pathophysiological mechanisms and diagnostic approaches for myocardial infarction occurring in the absence of obstructive coronary artery disease. The paper reviewed clinical presentation, underlying aetiologies, and diagnostic pathways relevant to this cardiac condition.
Topic tags
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