ACS in patients with NECA or Non- obstructive CAD

Our understanding of acute myocardial infarction (AMI) has evolved considerably over the past 50 years, which has given rise to innovative therapies that have improved patient outcomes. These innovations have primarily focused on alleviating atherothrombotic processes that obstruct coronary blood flow, evident in most patients with AMI. However, in approximately 1 in 10 patients (5–14% reported prevalence1–4) with AMI, angiography does not reveal obstructive coronary artery disease (CAD), so the pathophysiological processes responsible for the AMI are not immediately evident. These patients are labeled as having myocardial infarction with non-obstructive coronary arteries (MINOCA) , which is being increasingly recognized with the more widespread use of coronary angiography in AMI. Importantly, the management of these intriguing patients is predicated upon their initial recognition and subsequent evaluation to elucidate the pathophysiological processes responsible for their presentation. Since the term was first coined,clinical interest in patients with MINOCA has rapidly evolved and focused attention on the condition. The purpose of this talk is to summarize the contemporary understanding of MINOCA .