IMR Press / RCM / Volume 22 / Issue 3 / DOI: 10.31083/j.rcm2203073
Open Access Review
Management of myocardial infarction with Nonobstructive Coronary Arteries (MINOCA): a subset of acute coronary syndrome patients
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1 Department of Cardiology, Toulouse University Hospital, 31059 Toulouse, France
2 Faculty of Medicine, Holy Spirit University of Kaslik, 446 Jounieh, Lebanon
3 Faculty of Pharmacy, Lebanese University, 13-5033 Beirut, Lebanon
*Correspondence: (Jerome Roncalli)
Academic Editor: Leonardo De Luca
Rev. Cardiovasc. Med. 2021, 22(3), 625–634;
Submitted: 30 April 2021 | Revised: 4 June 2021 | Accepted: 11 June 2021 | Published: 24 September 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (

Myocardial infarction with non-obstructive coronary artery disease (MINOCA) represents a significant proportion (up to 15%) of acute myocardial infarction (AMI) population. MINOCA is diagnosed in patients who fullfilled the fourth universal definition of AMI in the absence of significant obstructive coronary artery disease on coronary angiography. MINOCA is a group of heterogeneous diseases with different pathophysiological mechanisms requiring multimodality imaging. Left ventriculography, cardiac magnetic resonance imaging and intra-coronary imaging (IVUS, OCT) are useful tools playing a pivotal role in the diagnostic work-up. There are no standard guidelines on the management of MINOCA patients and the therapeutic approach is personalized, thereby detecting the underlying aetiology is fundamental to initiate an early appropriate cause-targeted therapy.

Myocardial infarction
Fig. 1.
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