Myocardial Infarction with Non-Obstructive Coronary Arteries: A Puzzle in Search of a Solution

Background: The term myocardial infarction with non-obstructive coronary arteries (MINOCA), defines a puzzling event occurring in the absence of obstructive artery disease on angiography and without an overt potential cause. However, practical diagnostic work-up is often difficult, due to heterogeneous etiologies pathophysiology MINOCA. This review aims provide comprehensive overview focusing epidemiology, etiopathogenesis, tools therapeutic strategies for subjects MINOCA, order prompt accurate adequate approach this subset population. Methods: educational was carried out by following standard methods Cochrane Collaboration PRISMA statement. terms “MINOCA” OR (“myocardial infarction” AND (“non-obstructive” “non-obstructive”)) were searched PubMed Embase databases (in Title and/or Abstract) from 1st January 2003 until 31st May 2022. Results: Etiologic findings, clinical presentation degree hemodynamic impairment play pivotal role defining patient’s natural history prognostic outcome, may significantly impact decision-making approaches. Conclusions: Despite further advances strategies, MINOCA remains challenging conundrum practice. Clinicians should be aware different pathogenic mechanisms carry implement tailored approach.