Why the study?
Many uncertainties remain regarding the definition, clinical features, and management of patients with MINOCA.
This position paper from the Dutch ACS working group proposes a clinical diagnostic algorithm to guide the evaluation and management of patients with MINOCA, emphasizing it as a dynamic working diagnosis.
MINOCA warrants similar prognostic vigilance as obstructive MI; Level 5 data leaves open etiology-specific management trials.
Patients with myocardial infarction and non-obstructive coronary arteries (MINOCA), defined as angiographic stenosis <50%, represent a conundrum given the many potential underlying aetiologies. Possible causes of MINOCA can be subdivided into coronary, myocardial and non-cardiac disorders. MINOCA is found in up to 14% of patients presenting with an acute coronary syndrome. Clinical outcomes including mortality, and functional and psychosocial status, are comparable to those of patients with myocardial infarction and obstructive coronary arteries. However, many uncertainties remain regarding the definition, clinical features and management of these patients. This position paper of the Dutch ACS working group of the Netherlands Society of Cardiology aims to stress the importance of considering MINOCA as a dynamic working diagnosis and to guide the clinician in the management of patients with MINOCA by proposing a clinical diagnostic algorithm.
No takes yet. Share an insight, caveat, or question.
Pustjens et al. (2019) conducted a review in Myocardial infarction with non-obstructive coronary arteries (MINOCA). Diagnostic algorithm for MINOCA was evaluated. The Dutch ACS working group proposes a clinical diagnostic algorithm for MINOCA, emphasizing its role as a dynamic working diagnosis that requires further evaluation to determine the underlying etiology.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: