Utility of cardiac magnetic resonance imaging in troponin-positive chest pain with non-obstructive coronary arteries: literature review

Lee, Jonan Cy; Chiang, Jeanie Betsy; Ng, PP; Chow, Boris Ck; Cheng, Yi‐Wen; Wong, Chi Yuen

doi:10.12809/hkmj208690

Cited by 3 publications

(1 citation statement)

References 55 publications

(77 reference statements)

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“…Several studies supports the early use of CMR in MINOCA patients to find the underlying cause responsible for the myocardial ischemic event, with a diagnostic accuracy of about 90% when performed within a week from the index event [61,62]. Furthermore, another noninvasive imaging tool is coronary computed tomography angiography (CCTA); although it is not able to identify plaque rupture or erosion, it may be considered in the diagnostic workup to identify CAD after the ICA has excluded significant stenosis (>50%) (Figure 4) [57].…”

Section: Myocardial Infarction With Non-obstructive Coronary Arteries...mentioning

confidence: 80%

Advanced Cardiac Imaging and Women’s Chest Pain: A Question of Gender

Dell’Aversana,

Tedeschi,

Comune

et al. 2023

Diagnostics

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Awareness of gender differences in cardiovascular disease (CVD) has increased: both the different impact of traditional cardiovascular risk factors on women and the existence of sex-specific risk factors have been demonstrated. Therefore, it is essential to recognize typical aspects of ischemic heart disease (IHD) in women, who usually show a lower prevalence of obstructive coronary artery disease (CAD) as a cause of acute coronary syndrome (ACS). It is also important to know how to recognize pathologies that can cause acute chest pain with a higher incidence in women, such as spontaneous coronary artery dissection (SCAD) and myocardial infarction with non-obstructive coronary arteries (MINOCA). Coronary computed tomography angiography (CCTA) and cardiac magnetic resonance imaging (CMR) gained a pivotal role in the context of cardiac emergencies. Thus, the aim of our review is to investigate the most frequent scenarios in women with acute chest pain and how advanced cardiac imaging can help in the management and diagnosis of ACS.

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Section: Myocardial Infarction With Non-obstructive Coronary Arteries...mentioning

confidence: 80%

Advanced Cardiac Imaging and Women’s Chest Pain: A Question of Gender

Dell’Aversana,

Tedeschi,

Comune

et al. 2023

Diagnostics

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Role of Cardiac Magnetic Resonance Imaging in the Evaluation of MINOCA

Daneshrad

Ordovás

Sierra-Galan

et al. 2023

JCM

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Myocardial infarction with Non Obstructive Coronary Arteries (MINOCA) is defined by patients presenting with signs and symptoms similar to acute myocardial infarction, but are found to have non-obstructive coronary arteries angiography. What was once considered a benign phenomenon, MINOCA has been proven to carry with it significant morbidity and worse mortality when compared to the general population. As the awareness for MINOCA has increased, guidelines have focused on this unique situation. Cardiac magnetic resonance (CMR) has proven to be an essential first step in the diagnosis of patients with suspected MINOCA. CMR has also been shown to be crucial when differentiating between MINOCA like presentations such as myocarditis, takotsubo and other forms of cardiomyopathy. The following review focuses on demographics of patients with MINOCA, their unique clinical presentation as well as the role of CMR in the evaluation of MINOCA.

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Beyond the Obstructive Paradigm: Unveiling the Complex Landscape of Nonobstructive Coronary Artery Disease

Tudurachi,

Anghel,

Tudurachi

et al. 2024

JCM

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Traditionally focused on obstructive atherosclerosis, contemporary research indicates that up to 70% of patients undergoing coronary angiography for angina and ischemic symptoms do not exhibit significant stenoses. Nonobstructive coronary artery disease (CAD) has emerged as a prevalent phenotype among these patients. This review emphasizes the emerging understanding that nonobstructive coronary artery disease, encompassing conditions such as ANOCA (Angina with No Obstructive Coronary Artery Disease), INOCA (Ischemia with No Obstructive Coronary Artery Disease), and MINOCA (Myocardial Infarction with No Obstructive Coronary Arteries), represents the most prevalent phenotype in cardiac patients. It delves into the complex pathophysiology underlying these conditions, focusing on microvascular dysfunction and coronary vasoreactivity, which contribute to myocardial ischemia despite the absence of significant coronary obstructions. Additionally, the review critically examines the limitations of current treatments which primarily target obstructive lesions and underscores the necessity for tailored therapies that address the specific microvascular and immunoinflammatory pathways involved in nonobstructive CAD. The main focus of this review is to advocate for a shift in diagnostic and therapeutic strategies to better identify and manage this widely prevalent yet under-recognized subset of CAD.

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Utility of cardiac magnetic resonance imaging in troponin-positive chest pain with non-obstructive coronary arteries: literature review

Cited by 3 publications

References 55 publications

Advanced Cardiac Imaging and Women’s Chest Pain: A Question of Gender

Advanced Cardiac Imaging and Women’s Chest Pain: A Question of Gender

Role of Cardiac Magnetic Resonance Imaging in the Evaluation of MINOCA

Beyond the Obstructive Paradigm: Unveiling the Complex Landscape of Nonobstructive Coronary Artery Disease

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