Abstract
Patients with myocardial infarction and non-obstructive coronary arteries (MINOCA), defined as angiographic stenosis <50%, represent a conundrum given the many potential underlying aetiologies. Possible causes of MINOCA can be subdivided into coronary, myocardial and non-cardiac disorders. MINOCA is found in up to 14% of patients presenting with an acute coronary syndrome. Clinical outcomes including mortality, and functional and psychosocial status, are comparable to those of patients with myocardial infarction and obstructive coronary arteries. However, many uncertainties remain regarding the definition, clinical features and management of these patients. This position paper of the Dutch ACS working group of the Netherlands Society of Cardiology aims to stress the importance of considering MINOCA as a dynamic working diagnosis and to guide the clinician in the management of patients with MINOCA by proposing a clinical diagnostic algorithm.
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Details
1 Zuyderland Medical Centre, Department of Cardiology, Heerlen, The Netherlands
2 Amsterdam UMC, Department of Cardiology, location VU University Medical Centre, Amsterdam, The Netherlands (GRID:grid.12380.38) (ISNI:0000 0004 1754 9227)
3 Radboud University Medical Centre, Department of Cardiology, Nijmegen, The Netherlands (GRID:grid.10417.33) (ISNI:0000 0004 0444 9382)
4 St Antonius Hospital, Department of Cardiology, Nieuwegein, The Netherlands (GRID:grid.415960.f) (ISNI:0000 0004 0622 1269)
5 Leiden University Medical Centre, Department of Cardiology, Leiden, The Netherlands (GRID:grid.10419.3d) (ISNI:0000000089452978)
6 Amsterdam UMC, Department of Cardiology, location Academic Medical Centre, Amsterdam, The Netherlands (GRID:grid.10419.3d)
7 Jeroen Bosch Hospital, Department of Cardiology, ’s-Hertogenbosch, The Netherlands (GRID:grid.413508.b) (ISNI:0000 0004 0501 9798)
8 Treant Zorggroep, Department of Cardiology, location Bethesda, Hoogeveen, The Netherlands (GRID:grid.491363.a) (ISNI:0000 0004 5345 9413)
9 Zuyderland Medical Centre, Department of Cardiology, Heerlen, The Netherlands (GRID:grid.415960.f); Maastricht University Medical Centre, Department of Cardiology, Maastricht, The Netherlands (GRID:grid.412966.e) (ISNI:0000 0004 0480 1382)
10 Zuyderland Medical Centre, Department of Cardiology, Heerlen, The Netherlands (GRID:grid.412966.e); Maastricht University Medical Centre, Department of Cardiology, Maastricht, The Netherlands (GRID:grid.412966.e) (ISNI:0000 0004 0480 1382); Isala Hospital, Department of Cardiology, Zwolle, The Netherlands (GRID:grid.452600.5) (ISNI:0000 0001 0547 5927)