What is the clinical evidence from this study?

Study design: Case Report. Population: MINOCA (n=1). Intervention: Cardiac magnetic resonance (CMR).

What does this research mean for the field?

Cardiac magnetic resonance (CMR) imaging plays a pivotal role in clarifying the diagnosis, identifying missed culprit lesions, and guiding therapy in patients initially diagnosed with myocardial infarction with non-obstructive coronary arteries (MINOCA). Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Illustrate the diagnostic utility of cardiac magnetic resonance in identifying the culprit lesion and guiding medical therapy in myocardial infarction with non-obstructive coronary arteries.

September 15, 2026European Heart Journal Supplements

Multimodality Imaging and Minoca: The Role of Cardiac Mri in Identifying the Culprit Lesion

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Key result

CMR reveals transmural MI and guides culprit lesion discovery after an initial MINOCA diagnosis.

Population

A 65-year-old man presenting with chest pain diagnosed with MINOCA

Design

Case report

Follow-up

30 days

Authors

GSG ScherilloRegione Campania AAA AprileRegione Campania GAG ArenaRegione Campania

Discussion

Member takes

Implication

May guide antithrombotic escalation in select MINOCA cases; leaves open need for prospective validation before routine adoption.

Key Points

Illustrate the diagnostic utility of cardiac magnetic resonance in identifying the culprit lesion and guiding medical therapy in myocardial infarction with non-obstructive coronary arteries.
Evaluated a 65-year-old male with acute chest pain, elevated troponin levels, and non-obstructive coronary arteries via electrocardiography, echocardiography, and invasive angiography.
Performed cardiac magnetic resonance to assess tissue characterization, prompting targeted angiographic re-evaluation.
Cardiac magnetic resonance revealed myocardial edema, late gadolinium enhancement, and microvascular obstruction in the inferolateral and lateral segments, confirming transmural myocardial infarction.
Re-evaluation of the initial angiogram identified a previously missed, hazy culprit lesion in the proximal circumflex/obtuse marginal branch.
Therapy was escalated to triple antithrombotic therapy with the addition of clopidogrel, and the patient remained asymptomatic at 30-day follow-up.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 65-year-old man presenting with MINOCA who underwent cardiac magnetic resonance imaging to identify the culprit lesion.

Intervention

Cardiac magnetic resonance (CMR) imaging

Outcome

Identification of the culprit lesion and clarification of diagnosis

This case highlights the pivotal role of cardiac MRI in clarifying the diagnosis and guiding antithrombotic therapy in patients with MINOCA.

Cite This Study

Scherillo et al. (2026) conducted a case report in MINOCA (n=1). Cardiac magnetic resonance (CMR) was evaluated. Cardiac magnetic resonance imaging identified a transmural myocardial infarction and guided the retrospective identification of the culprit lesion in a 65-year-old man initially diagnosed with MINOCA.

synapsesocial.com/papers/6aa90187eed42882c1fc19d7 https://doi.org/10.1093/eurheartjsupp/suag058.499

Topics

Percutaneous coronary intervention Chronic total occlusion PCI

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Multimodality Imaging and Minoca: The Role of Cardiac Mri in Identifying the Culprit Lesion

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Multimodality Imaging and Minoca: The Role of Cardiac Mri in Identifying the Culprit Lesion

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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Topics

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