[MINOCA-myocardial infarction with nonobstructive coronary arteries]. / MINOCA ­ Myokardinfarkt mit nichtobstruktiven Koronararterien.

ABSTRACT

BACKGROUND: Myocardial infarction with nonobstructive coronary arteries (MINOCA) accounts for 5-10% of all presentations of acute myocardial infarction. OBJECTIVES: To outline the role of cardiovascular magnetic resonance (CMR) in patients with suspected MINOCA. MATERIALS AND METHODS: Current guidelines for the use of CMR in suspected MINOCA are summarized. Clinical cases with typical CMR findings are presented. RESULTS: In 2019, the American Heart Association published a revised definition of the term MINOCA, which was recently adopted in the European Society of Cardiology 2020 guidelines on acute coronary syndromes without persistent ST-segment elevation (NSTE-ACS). The guidelines indicate that a CMR is recommended (class 1B) in all MINOCA cases with no obvious cause. CONCLUSION: The major strength of CMR imaging is to differentiate nonischemic from ischemic etiologies of myocardial injury. This makes CMR the most important noninvasive diagnostic tool for the differential diagnosis of patients with suspected MINOCA.