Infarkt miokarda bez opstrukcije koronarnih arterija (MINOCA)

Abstract

Myocardial infarction with no coronary artery obstruction (MINOCA) is a heterogenous clinical entity characterized by clinical signs of acute myocardial infarction (AMI), lack of coronary artery disease (stenosis ≥50%) and obvious cause for acute presentation at the time of angiography. The prevalence of MINOCA in patients with the diagnosis of AMI is between 1% and 14%. It is more common in women and patients presenting as a non-ST elevation myocardial infarction (NSTEMI). Although dependant on the cause, the prognosis of MINOCA is severe with one-year mortality at about 3.5%. Various patophysiological mechanisms that cause MINOCA include: plaque disruption, coronary artery spasm, spontanious disection of coronary arteries, coronary thrombosis/embolism and coronary microvascular dysfunction. Defining the cause of MINOCA enables the doctor to choose the optimal form of treatment.

Keywords

• myocardial infarction
• minoca
• patophysiology
• therapy