Siemens Healthineers - Novel insights into MINOCA and INOCA: Resolving diagnostic dilemmas-siemens-healthineers_CVC_Webinar

Video Transcription

Video Summary

The webinar discussed MINOCA and INOCA, two important causes of chest pain and troponin rise without obstructive coronary artery disease. Chiara Bucciarelli-Ducci explained that MINOCA is now defined as myocardial infarction with no obstructive coronary arteries, while non-ischemic mimics such as myocarditis and Takotsubo syndrome should be separated from true infarction. She emphasized cardiac MRI (CMR) as a key diagnostic tool because it can identify edema, scar, and the pattern of injury, helping distinguish ischemic from non-ischemic causes. Clinical examples showed CMR confirming acute myocarditis in one patient and a small inferior myocardial infarction in another. She also reviewed evidence that CMR changes diagnosis or management in a substantial proportion of patients and is recommended in guidelines.<br /><br />Colin Berry then focused on INOCA in chronic ischemia, highlighting coronary microvascular dysfunction and vasospastic angina. He explained how functional imaging, especially stress perfusion MRI and PET, can reveal impaired myocardial blood flow that anatomical tests may miss. He discussed diagnostic criteria for microvascular angina and the growing role of personalized imaging strategies. The session concluded that MINOCA and INOCA are common, under-recognized, and increasingly diagnosable with modern imaging, improving care and outcomes.

Keywords

MINOCA

INOCA

cardiac MRI

myocarditis

Takotsubo syndrome

coronary microvascular dysfunction

vasospastic angina

stress perfusion MRI

PET imaging