TY - JOUR
T1 - The evolving role of cardiac imaging in patients with myocardial infarction and non-obstructive coronary arteries
AU - Montone, Rocco Antonio
AU - Jang, Ik-Kyung
AU - Beltrame, John F.
AU - Sicari, Rosa
AU - Meucci, Maria Chiara
AU - Bode, Michael
AU - Gaibazzi, Nicola
AU - Niccoli, Giampaolo
AU - Bucciarelli-Ducci, Chiara
AU - Crea, Filippo
PY - 2021
Y1 - 2021
N2 - Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) represents a heterogeneous clinical conundrum accounting for about 6%–8% of all acute MI who are referred for coronary angiography. Current guidelines and consensus documents recommend that these patients are appropriately diagnosed, uncovering the causes of MINOCA, so that specific therapies can be prescribed. Indeed, there are a variety of causes that can result in this clinical condition, and for this reason diagnostic cardiac imaging has an emerging critical role in the assessment of patients with suspected or confirmed MINOCA. In last years, different cardiac imaging techniques have been evaluated in this context, and the comprehension of their strengths and limitations is of the utmost importance for their effective use in clinical practice. Moreover, recent evidence is clearly suggesting that a multimodality cardiac imaging approach, combining different techniques, seems to be crucial for a proper management of MINOCA. However, great variability still exists in clinical practice in the management of patients with suspected MINOCA, also depending on the availability of diagnostic tools and local expertise. Herein, we review the current knowledge supporting the use of different cardiac imaging techniques in patients with MINOCA, underscoring the importance of a comprehensive multimodality cardiac imaging approach and proposing a practical diagnostic algorithm to properly identify and treat the specific causes of MINOCA, in order to improve prognosis and the quality of life in these patients.
AB - Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) represents a heterogeneous clinical conundrum accounting for about 6%–8% of all acute MI who are referred for coronary angiography. Current guidelines and consensus documents recommend that these patients are appropriately diagnosed, uncovering the causes of MINOCA, so that specific therapies can be prescribed. Indeed, there are a variety of causes that can result in this clinical condition, and for this reason diagnostic cardiac imaging has an emerging critical role in the assessment of patients with suspected or confirmed MINOCA. In last years, different cardiac imaging techniques have been evaluated in this context, and the comprehension of their strengths and limitations is of the utmost importance for their effective use in clinical practice. Moreover, recent evidence is clearly suggesting that a multimodality cardiac imaging approach, combining different techniques, seems to be crucial for a proper management of MINOCA. However, great variability still exists in clinical practice in the management of patients with suspected MINOCA, also depending on the availability of diagnostic tools and local expertise. Herein, we review the current knowledge supporting the use of different cardiac imaging techniques in patients with MINOCA, underscoring the importance of a comprehensive multimodality cardiac imaging approach and proposing a practical diagnostic algorithm to properly identify and treat the specific causes of MINOCA, in order to improve prognosis and the quality of life in these patients.
KW - Cardiac Imaging Techniques
KW - Cardiac magnetic resonance
KW - Computed Tomography Angiography
KW - Coronary Angiography
KW - Coronary Vessels
KW - Echocardiography
KW - Humans
KW - MINOCA
KW - Magnetic Resonance Imaging
KW - Myocardial infarction
KW - Optical coherence tomography
KW - Precision medicine
KW - Predictive Value of Tests
KW - Prognosis
KW - Tomography, Optical Coherence
KW - Ultrasonography, Interventional
KW - Cardiac Imaging Techniques
KW - Cardiac magnetic resonance
KW - Computed Tomography Angiography
KW - Coronary Angiography
KW - Coronary Vessels
KW - Echocardiography
KW - Humans
KW - MINOCA
KW - Magnetic Resonance Imaging
KW - Myocardial infarction
KW - Optical coherence tomography
KW - Precision medicine
KW - Predictive Value of Tests
KW - Prognosis
KW - Tomography, Optical Coherence
KW - Ultrasonography, Interventional
UR - http://hdl.handle.net/10807/204501
U2 - 10.1016/j.pcad.2021.08.004
DO - 10.1016/j.pcad.2021.08.004
M3 - Article
SN - 0033-0620
SP - 78
EP - 87
JO - Progress in Cardiovascular Diseases
JF - Progress in Cardiovascular Diseases
ER -