Role of Cardiac Magnetic Resonance Imaging in the Evaluation of MINOCA

Figures

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  Figure 1. Demonstrative case of myocarditis. Case of a 21-year-old male patient presenting with chest pain. Found to have normal coronaries, SSFP cine imaging showed borderline LV function, EF 54%, and subepicardial basal-mid inferolateral late gadolinium enhancement (arrows), suggestive of myocarditis.

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  Figure 2. Demonstrative case of a spontaneous coronary artery dissection. A 47-year-old female presenting with chest pain, with nonobstructive coronary artery disease. On SSFP cine imaging showed borderline cardiac function with EF 50% with myocardial edema of the inferolateral wall and corresponding transmural late gadolinium enhancement in inferolateral wall with microvascular obstruction. On cardiac catheterization she was found to have type 2B SCAD lesion of the left circumflex artery.

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  Figure 3. Demonstrative case of a myocardial infarction and acute LAD vasospasm. A 52 yo female with recurrent admissions with chest pain presented anterior STEMI on EKG, troponin I = 0.87, on cardiac catheterization found to have 50% LAD lesion responsive to nitroglycerine, LVEF was found to be 25% on initial TTE. Areas 1–3 suggest areas of interest to measure mapping. The presence of myocardial edema in the LAD territory without any obvious late gadolinium enhancement, suggested myocardial stunning.

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  Figure 4. Role of CMR in patients presenting with suspected MINOCA.