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May 24, 2026Case Reports in Vascular MedicineOpen Access

CCB and nicorandil normalize symptoms and CMR in a case of SSc-associated MINOCA and CMD.

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Why the study?

MINOCA attributable to SSc-related CMD confirmed by invasive coronary function testing and CMR is not widely reported.

Does vasodilator therapy improve symptoms and CMR abnormalities in a patient with systemic sclerosis-associated MINOCA driven by coronary microvascular dysfunction?

Population

One 76-year-old woman with SSc and interstitial pneumonia presenting with MINOCA

Design

Case report

Follow-up

1 year

Key result

Treatment with a calcium-channel blocker and nicorandil normalized symptoms and CMR abnormalities at 3 months in a 76-year-old woman with SSc-associated MINOCA and CMD (IMR 30.5; CFR 1.7).

Authors

YOYuya OhgaTNTatsuya NishikawaAHAkeo Hirai

Discussion

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Overview

Supports vasodilator reversibility in SSc-MINOCA; hypothesis-generating and requires prospective trials.

Key Points

  • To report a case of myocardial infarction with nonobstructive coronary arteries linked to systemic sclerosis-related coronary microvascular dysfunction.
  • Case presentation of a 76-year-old woman with systemic sclerosis and myocardial infarction.
  • Diagnostic methods included electrocardiography, echocardiography, coronary angiography, and cardiac magnetic resonance imaging, alongside invasive physiological assessment.
  • Treatment involved a calcium-channel blocker and nicorandil, with follow-up assessments using CMR.
  • Coronary microvascular dysfunction was identified with IMR 30.5 and CFR 1.7 after acetylcholine provocation testing.
  • At 3-month follow-up, symptoms and electrocardiographic changes normalized, indicating reversal of ischemic injury.
  • No recurrence of symptoms occurred within 1 year of follow-up.

Study Design

Type

Case Report (n=1)

Structured PICO

Does vasodilator therapy improve symptoms and CMR abnormalities in a patient with systemic sclerosis-associated MINOCA driven by coronary microvascular dysfunction?

P
Population
76-year-old woman with systemic sclerosis and interstitial pneumonia presenting with myocardial infarction with nonobstructive coronary arteries (MINOCA)
I
Intervention
Calcium-channel blocker and nicorandil, guided by invasive coronary function testing and cardiac magnetic resonance (CMR)
O
Outcome
Resolution of symptoms, electrocardiographic changes, and CMR abnormalitiessurrogate

Comprehensive invasive coronary function testing and serial CMR can diagnose and document the reversibility of systemic sclerosis-associated MINOCA driven by coronary microvascular dysfunction when treated with vasodilators.

Cite This Study

Ohga et al. (2026) conducted a case report in Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA) associated with Systemic Sclerosis (n=1). Calcium-channel blocker and nicorandil was evaluated. Treatment with a calcium-channel blocker and nicorandil normalized symptoms and CMR abnormalities at 3 months in a 76-year-old woman with SSc-associated MINOCA and CMD (IMR 30.5; CFR 1.7).

synapsesocial.com/papers/6a1295f648a0ea166567249dhttps://doi.org/10.1155/crvm/9472631
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