What is the clinical evidence from this study?

Study design: Review. Population: Myocardial infarction with non-obstructive coronary arteries (MINOCA). Intervention: Multimodal cardiac imaging and blood biomarkers.

August 23, 2026Lynchburg Journal of Medical Science

Hidden Infarctions: Understanding and Managing Myocardial Infarction with Non-Obstructive Coronary Arteries Through a Multimodal Lens

Q: What are the key findings of this study?

Early use of multimodal cardiac imaging improves diagnostic accuracy for MINOCA, which accounts for 5-15% of myocardial infarctions, though treatment remains highly individualized.

Q: What does this research mean for the field?

Early use of multimodal cardiac imaging improves diagnostic accuracy for MINOCA, which accounts for 5-15% of myocardial infarctions, though treatment remains highly individualized. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Early multimodal cardiac imaging improves diagnostic accuracy for MINOCA, though treatment remains highly individualized.

or 5

Why the study?

MINOCA carries morbidity and mortality comparable to obstructive CAD-related MI, but treatment remains individualized due to etiologic heterogeneity and limited evidence.

Design

Narrative review

Authors

CECatalina Esquivel

Discussion

Member takes

Overview

Highlights need for targeted MINOCA evaluation in women and minorities; leaves optimal management strategies open for prospective trials.

Key Points

To synthesize current diagnostic and therapeutic strategies for myocardial infarction with non-obstructive coronary arteries (MINOCA) and emphasize mechanistic assessment via multimodal imaging and biomarkers.
Conducted a narrative review of key literature, clinical evidence, and guideline recommendations regarding MINOCA.
Evaluated the diagnostic utility of multimodal imaging, including cardiac magnetic resonance imaging, optical coherence tomography, and intravascular ultrasound, across distinct underlying mechanisms.
MINOCA accounts for 5% to 15% of all myocardial infarctions, disproportionately affects women and minority groups, and carries morbidity and mortality rates comparable to obstructive coronary artery disease.
Early use of cardiac magnetic resonance imaging, optical coherence tomography, and intravascular ultrasound enhances diagnostic precision to identify specific etiologies such as plaque disruption, coronary vasospasm, microvascular dysfunction, or spontaneous dissection.
Management remains highly variable and lacks standardized protocols due to diverse disease mechanisms and a scarcity of randomized trials evaluating etiology-targeted therapies.

Structured PICO

Population

Patients with myocardial infarction with non-obstructive coronary arteries (MINOCA), defined by clinical evidence of myocardial ischemia with <50% coronary stenosis on angiography.

Exposure

Diagnostic and management strategies including multimodal cardiac imaging (cardiac magnetic resonance imaging, optical coherence tomography, intravascular ultrasound) and blood biomarkers.

Early, mechanism-based evaluation using multimodal imaging is essential for improving diagnostic accuracy and outcomes in patients with MINOCA.

Limitations

Diagnostic variability
Delayed imaging
Lack of standardized treatment protocols
Limited evidence guiding therapy
diagnostic variability
delayed imaging
lack of standardized treatment protocols
limited evidence guiding therapy

Cite This Study

Catalina Esquivel (2026) conducted a review in Myocardial infarction with non-obstructive coronary arteries (MINOCA). Multimodal cardiac imaging and blood biomarkers was evaluated. Early use of multimodal cardiac imaging improves diagnostic accuracy for MINOCA, which accounts for 5-15% of myocardial infarctions, though treatment remains highly individualized.

synapsesocial.com/papers/6a8aad167677a341144455a2 https://doi.org/10.63932/3067-7106.1075

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August 23, 2026Lynchburg Journal of Medical Science

Hidden Infarctions: Understanding and Managing Myocardial Infarction with Non-Obstructive Coronary Arteries Through a Multimodal Lens

View Full Paper

Ask AI

Bookmark

Key result

Early multimodal cardiac imaging improves diagnostic accuracy for MINOCA, though treatment remains highly individualized.

or 5

Why the study?

MINOCA carries morbidity and mortality comparable to obstructive CAD-related MI, but treatment remains individualized due to etiologic heterogeneity and limited evidence.

Design

Narrative review

Authors

CECatalina Esquivel

Discussion

Member takes

Overview

Highlights need for targeted MINOCA evaluation in women and minorities; leaves optimal management strategies open for prospective trials.

Key Points

To synthesize current diagnostic and therapeutic strategies for myocardial infarction with non-obstructive coronary arteries (MINOCA) and emphasize mechanistic assessment via multimodal imaging and biomarkers.
Conducted a narrative review of key literature, clinical evidence, and guideline recommendations regarding MINOCA.
Evaluated the diagnostic utility of multimodal imaging, including cardiac magnetic resonance imaging, optical coherence tomography, and intravascular ultrasound, across distinct underlying mechanisms.
MINOCA accounts for 5% to 15% of all myocardial infarctions, disproportionately affects women and minority groups, and carries morbidity and mortality rates comparable to obstructive coronary artery disease.
Early use of cardiac magnetic resonance imaging, optical coherence tomography, and intravascular ultrasound enhances diagnostic precision to identify specific etiologies such as plaque disruption, coronary vasospasm, microvascular dysfunction, or spontaneous dissection.
Management remains highly variable and lacks standardized protocols due to diverse disease mechanisms and a scarcity of randomized trials evaluating etiology-targeted therapies.

Structured PICO

Population

Patients with myocardial infarction with non-obstructive coronary arteries (MINOCA), defined by clinical evidence of myocardial ischemia with <50% coronary stenosis on angiography.

Exposure

Diagnostic and management strategies including multimodal cardiac imaging (cardiac magnetic resonance imaging, optical coherence tomography, intravascular ultrasound) and blood biomarkers.

Early, mechanism-based evaluation using multimodal imaging is essential for improving diagnostic accuracy and outcomes in patients with MINOCA.

Limitations

Diagnostic variability
Delayed imaging
Lack of standardized treatment protocols
Limited evidence guiding therapy
diagnostic variability
delayed imaging
lack of standardized treatment protocols
limited evidence guiding therapy

Cite This Study

synapsesocial.com/papers/6a8aad167677a341144455a2 https://doi.org/10.63932/3067-7106.1075

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