Copyright
©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Dec 26, 2019; 11(12): 305-315
Published online Dec 26, 2019. doi: 10.4330/wjc.v11.i12.305
Published online Dec 26, 2019. doi: 10.4330/wjc.v11.i12.305
Myocardial infarction with non-obstructive coronary arteries: A comprehensive review and future research directions
Rafael Vidal-Perez, Charigan Abou Jokh Casas, Rosa Maria Agra-Bermejo, Belén Alvarez-Alvarez, Pedro Rigueiro Veloso, Jose Maria Garcia Acuña, Jose Ramon Gonzalez-Juanatey, Cardiology Department, Hospital Clinico Universitario de Santiago, Santiago de Compostela 15706, Spain
Rosa Maria Agra-Bermejo, Belén Alvarez-Alvarez, Pedro Rigueiro Veloso, Jose Maria Garcia Acuña, Jose Ramon Gonzalez-Juanatey, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Santiago de Compostela 15706, Spain
Julia Grapsa, Cardiology Department, St Bartholomew Hospital, Barts Health Trust, London EC1A 7BE, United Kingdom
Ricardo Fontes-Carvalho, Cardiology Department, Centro Hospitalar Gaia, Vila Nova Gaia 4434-502, Portugal
Ricardo Fontes-Carvalho, Faculty of Medicine University of Porto, Porto 4200-319, Portugal
Author contributions: Vidal-Perez R and Abou Jokh Casas C contributed equally to this work; Vidal-Perez R and Abou Jokh Casas C designed, edited and wrote the paper; Agra-Bermejo RM, Alvarez -Alvarez B, Grapsa J, Fontes-Carvalho R, Rigueiro Veloso P, Garcia Acuña JM and Gonzalez-Juanatey JR contributed to the critical revision and editing of the paper.
Conflict-of-interest statement: No potential conflicts of interest.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Rafael Vidal-Perez, MD, PhD, Doctor, Reader (Associate Professor), Staff Physician, Heart failure unit, Cardiology department, USC University Hospital Complex, Travesía da Choupana s/n, Santiago de Compostela, A Coruña 15706, Spain. rafavidal@hotmail.com
Telephone: +34-981950757
Received: March 12, 2019
Peer-review started: March 15, 2019
First decision: June 6, 2019
Revised: September 17, 2019
Accepted: October 27, 2019
Article in press: October 27, 2019
Published online: December 26, 2019
Peer-review started: March 15, 2019
First decision: June 6, 2019
Revised: September 17, 2019
Accepted: October 27, 2019
Article in press: October 27, 2019
Published online: December 26, 2019
Core Tip
Core tip: Myocardial infarction with non-obstructive coronary arteries (MINOCA) differs from type 1 myocardial infarction regarding patient characteristics, presentation, physiopathology, management, treatment, and prognosis. In the absence of relevant coronary artery disease, myocardial ischaemia might be triggered by an acute event in epicardial coronary arteries, coronary microcirculation, or both. Epicardial causes of MINOCA include coronary plaque disruption, coronary dissection, and coronary spasm. Diagnostic strategies include invasive and non-invasive techniques recently embracing intravascular ultrasound and cardiac magnetic resonance. MINOCA is not a benign diagnosis, and its polymorphic forms differ in prognosis.