Case Session 04: Miscellaneous (2018)-Suspected Myocardial Infarction and Non-Obstructive Coronary Arteries: now what?

Suspected Myocardial Infarction and Non-Obstructive Coronary Arteries: now what?

Video Transcription

Video Summary

The speaker presents two similar chest-pain cases with elevated troponin, minor ECG changes, normal coronary angiograms, and normal echocardiograms, where CMR distinguished acute myocarditis from ischemic injury. This illustrates MINOCA, a syndrome including myocarditis, myocardial infarction, and Takotsubo. A meta-analysis showed MINOCA is about 6% of MIs, often affects younger women, and is not benign. In a study of 125 patients, CMR gave a definitive diagnosis in 87% and added substantial value over expert cardiology opinion, which often disagreed. Early CMR, ideally within a week, is emphasized as an objective diagnostic tool.

Keywords

MINOCA

cardiac magnetic resonance

myocarditis

troponin elevation

myocardial infarction