Key result
CMR detects multi-territory ischemia to confirm myxoma-associated coronary embolism as the cause of MINOCA.
Why the study?
The diagnostic value of multimodal imaging in identifying rare causes of myocardial infarction such as myxoma-associated coronary embolism was explored.
Case Report (n=1)
This case demonstrates the utility of cardiac magnetic resonance imaging in identifying rare causes of MINOCA, such as myxoma-associated coronary embolism.
Multimodal imaging may uncover rare embolic MINOCA causes; leaves open standardized protocols pending larger studies.
Aims: Explore the diagnostic value of multimodal imaging in identifying considerably rare causes of myocardial infarction. Methods and results: We report a case of myocardial infarction with non-obstructive coronary arteries (MINOCA) probably due to coronary embolism associated with a left atrial myxoma. A 56-year-old male presented with non-ST-elevation myocardial infarction, with coronary angiography showing mild coronary atherosclerosis without significant epicardial stenosis. Transthoracic echocardiography and cardiac magnetic resonance imaging (CMR) revealed a large left atrial mass, suspected to be an atrial myxoma. CMR also showed an ischaemic pattern involving multiple coronary territories, suggesting coronary embolism as the cause of the MINOCA. The patient underwent successful surgical excision of the left atrial mass, and histopathology confirmed the diagnosis of cardiac myxoma. Conclusions: This case highlights the relevance of CMR in detecting ischaemic patterns in patients with a working diagnosis of MINOCA and underlines the diagnostic value of multimodal imaging in identifying considerably rare causes of myocardial infarction, such as myxoma-associated coronary embolism.
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Pasquini et al. (2024) conducted a case report in Myocardial infarction with non-obstructive coronary arteries (MINOCA) (n=1). Cardiac magnetic resonance imaging (CMR) was evaluated on Detection of ischaemic patterns and underlying cause of MINOCA. Cardiac magnetic resonance imaging successfully identified an ischaemic pattern involving multiple coronary territories, confirming myxoma-associated coronary embolism as the cause of MINOCA.
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