What is the clinical evidence from this study?

Study design: Case Report. Population: Myocardial infarction with non-obstructive coronary artery disease (MINOCA) (n=1). Intervention: Medical therapy (DAPT, beta blocker, ACE inhibitor, calcium channel blocker, diuretic, PPI, nitroglycerin).

January 1, 2025Open Access

Myocardial infarction with non-obstructive coronary artery disease (MINOCA): Case report

DĆDanijela ĆirićZdravstveni centar

Key Result

A 60-year-old female patient with typical NSTEMI presentation and elevated troponin was diagnosed with MINOCA after normal coronary angiography and successfully treated with medical therapy.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 60-year-old female patient presenting with chest pain and elevated troponin levels who was diagnosed with MINOCA after a normal coronary angiography.

Intervention

Medical therapy including low-molecular-weight heparin, dual antiplatelet therapy (DAPT), nebivolol, ACE inhibitor, calcium channel blocker, diuretic, proton pump inhibitor, and nitroglycerin.

This case report highlights the clinical presentation and management of MINOCA, emphasizing the need for appropriate diagnostic evaluation and medical therapy in patients with ACS symptoms but non-obstructive coronary arteries.

Limitations

Single case report
The definitive underlying cause of MINOCA was not established during the initial hospitalization, pending cardiac magnetic resonance imaging.

Abstract

Introduction: Acute coronary syndrome type myocardial infarction with non-obstructive coronary artery disease (MINOCA) represents a myocardial infarction without coronary artery stenosis or with stenosis less than 50%. The aim of this paper is to highlight MINOCA as a relatively new entity in cardiology, the importance of early diagnosis and timely treatment, as well as the application of primary and secondary prevention of cardiovascular diseases along with the modification of risk factors for these conditions. Case presentation: A 60-year-old female patient presents with chest pain described as tightness and pressure. The physical examination is normal, while the electrocardiogram shows ST-segment depressions in leads V4-V6 ranging from 0.5 mm to 1 mm. The patient was treated according to the protocol for non-ST-elevation myocardial infarction (NSTEMI). Coronary angiography was immediately performed and found to be normal. Treatment was continued with medical therapy. Conclusion: MINOCA encompasses a heterogeneous group of patients who experience myocardial infarction but do not have significant coronary artery obstruction on angiogram. Our patient had a typical presentation of non-ST-elevation infarction and was treated with medical therapy to reduce cardiovascular risk for future events and improve outcomes.

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