医学
内科学
心脏病学
心肌梗塞
冠状动脉
梗塞
冠状动脉疾病
作者
Andrea Buono,Patrizia Pedrotti,Francesco Soriano,Nicolás Veas,Fabrizio Oliva,Jacopo Oreglia,Enrico Ammirati
出处
期刊:Giornale italiano di cardiologia
日期:2019-09-01
卷期号:20 (9): 499-511
被引量:2
摘要
The term MINOCA (myocardial infarction with non-obstructive coronary arteries) defines acute myocardial infarction with angiographic evidence of no significant coronary artery stenosis. Heterogeneous diseases are labelled as MINOCA. Incidence and epidemiological aspects differ on the basis of etiological causes. MINOCA include plaque (causing <50% stenosis) rupture or erosion, coronary embolism and dissection, and coronary artery spasm. Diagnosis may require multiple diagnostic tools, including cardiac imaging or provocative tests, in addition to standard coronary angiography, according to clinical suspicion. Cardiac magnetic resonance plays a key role in confirming the diagnosis and excluding other diseases with similar clinical presentation. Prognosis is not as benign as previously thought, on the opposite it is characterized by morbidity and mortality rates similar to other forms of myocardial infarction. Once the causative mechanism has been identified, appropriate therapy can be delivered.
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