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MINOCA: A Working Diagnosis.
Cureus
November 2023
Cardiovascular Disease, Centro Médico Episcopal San Lucas, Ponce, PRI.
Cases of patients presenting with myocardial infarction (MI) without angiographic obstructive CAD are not trivial and have significant prevalence. "The Fourth Universal Definition of MI" (4UDMI) published in 2018 introduced MI with non-obstructive coronary arteries (MINOCA). The new section was of great importance as it validated the diagnosis by defining its criteria and recognizing its presence in the community and the need for further investigation.
View Article and Find Full Text PDFNot So Benign Chest Pain in the Young: A Story of Spontaneous Coronary Artery Dissection and Fibromuscular Dysplasia.
J Investig Med High Impact Case Rep
December 2023
Spontaneous coronary artery dissection (SCAD) is a rare clinical entity, often presenting similar to atherosclerotic acute coronary syndrome (ACS), although it is a non-atherosclerotic, non-traumatic, and non-iatrogenic coronary artery pathology. We report the case of a 36-year-old woman who presented with substernal, pressure-like chest pain without aggravating, alleviating, or associated symptoms. Initial evaluation revealed elevated troponin levels which peaked at 8.
View Article and Find Full Text PDFAn Unusual Presentation of SCAD in a Young Male Soldier.
Mil Med
February 2024
Department of Hematology/Oncology, Tripler Army Medical Center, Honolulu, HI 96859, USA.
Spontaneous coronary artery dissection (SCAD) is a non-atherosclerotic cause of myocardial infarction and sudden cardiac death in young individuals without significant cardiovascular risk factors. The etiology of SCAD appears to be multifactorial and is often precipitated by physical and emotional stress superimposed on underlying arteriopathy, connective tissue disorders, systemic inflammatory disorders, genetic factors, and hormonal influences. There are no current societal guidelines to stratify young soldiers' risk of developing SCAD.
View Article and Find Full Text PDFGenome-wide association study of thoracic aortic aneurysm and dissection in the Million Veteran Program.
Nat Genet
July 2023
Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Article Synopsis
- A genome-wide association study (GWAS) was conducted on thoracic aortic aneurysms and dissections (TAAD) involving nearly 450,000 participants, identifying 21 genetic risk loci, 17 of which are new findings.
- The study utilized various analytical methods to pinpoint specific genes and cell types linked to TAAD, reinforcing that it is a unique condition not caused by the usual vascular disease factors.
- The research highlights that the genetic basis of TAAD is complex, similar to other traits, and is not only influenced by significant protein-altering gene variants.
Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic Susceptibility.
J Clin Med
May 2023
Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico, 155, 00161 Rome, Italy.
Among the most common causes of death worldwide, ischemic heart disease (IHD) is recognized to rank first. Even if atherosclerotic disease of the epicardial arteries is known as the leading cause of IHD, the presence of myocardial infarction with non-obstructive coronary artery disease (MINOCA) is increasingly recognized. Notwithstanding the increasing interest, MINOCA remains a puzzling clinical entity that can be classified by distinguishing different underlying mechanisms, which can be divided into atherosclerotic and non-atherosclerotic.
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