Myocardial Infarction With Non-obstructive Coronary Arteries: A Clinical Conundrum.

Autor:	Allison EL; Department of Internal Medicine, State University of New York Downstate Medical Center, Brooklyn, USA., Palmer WA; Department of Internal Medicine, State University of New York Downstate Medical Center, Brooklyn, USA., Rattan K; Department of Internal Medicine, State University of New York Downstate Medical Center, Brooklyn, USA., Seenarine N; Department of Internal Medicine, State University of New York Downstate Medical Center, Brooklyn, USA., Schrem E; Department of Cardiology, State University of New York Downstate Medical Center, Brooklyn, USA., Mills R; Department of Internal Medicine, Veterans Affairs New York Medical Center, Brooklyn, USA., Mitre CA; Department of Cardiology, Veterans Affairs New York Harbor Healthcare System, Brooklyn Campus, Brooklyn, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jul 09; Vol. 16 (7), pp. e64135. Date of Electronic Publication: 2024 Jul 09 (Print Publication: 2024).
DOI:	10.7759/cureus.64135
Abstrakt:	Myocardial infarction with non-obstructive coronary arteries (MINOCA) is defined by the presence of positive cardiac biomarkers with clinical evidence of infarction, the absence of significant coronary stenosis (≥50%) on angiography, and the lack of alternative diagnosis for the index presentation. MINOCA poses a diagnostic and therapeutic challenge due to the various pathophysiologic mechanisms underlying its presentation. Coronary artery plaque disruption is recognized as a crucial mechanism contributing to MINOCA. Plaque rupture and thrombus formation with subsequent myocardial ischemia may occur without significant luminal narrowing. A high index of suspicion is needed to make an early diagnosis. Here, a 68-year-old African American male patient presented with substernal chest pain, nonspecific ST segment changes on electrocardiogram, and elevation in cardiac biomarkers only one day after undergoing diagnostic cardiac catheterization that revealed non-obstructed coronary arteries. This case provides an example of MINOCA occurring secondary to suspected coronary artery plaque disruption in the setting of recent cardiac catheterization. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Allison et al.)
Databáze:	MEDLINE
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