Acute coronary syndrome without coronary obstructions: Diagnosis and treatment

>Myocardial infarction with no obstructive coronary atherosclerosis (MINOCA) is a syndrome with different causes. Its prevalence ranges between 5% and 25% of all myocardial infarctions. The prognosis is extremely variable, as it strictly depends on the cause of MINOCA. Clinical history, electrocardiography, cardiac enzymes, echocardiography, coronary angiography, and left ventricular angiography represent first-level diagnostic investigations to identify the causes of MINOCA. This preliminary step helps divide patients presenting with epicardial or microvascular patterns and to perform specific additional tests for an adequate management workflow. This article will focus on the diagnosis and treatment of MINOCA.