Non-significant Disease Presenting as Myocardial Infarction in the Absent of

Obstructive Coronary Artery Disease ( MINOCA) in Men: a Case Report

A.Wicaksono 1 , R. Herdyanto2, 1Medical Intern, RSUD Sosodoro Djatikoesoemo, Bojonegoro, East Java, Indonesia; 2Department of

Cardiovascular, RSUD Sosodoro Djatikoeseomo, Bojonegoro, East Java, Indonesia.

Myocardial infarction in the absence of obstructive coronary artery disease

(MINOCA) is a variant of acute myocardial infarction (AMI) with no evidence of

obstructive coronary artery. MINOCA had been found in 8,7 % of patients with AMI.

A 44 years old male presented

with acute typical chest pain, dyspnoea,

and cold sweat after syncope, has been

smoking for 10 years with hypotension,

ST-segment elevation on limb lead II -

III, AVF, and elevated troponin I on the

second test. Echocardiography test

showed an LV regional wall motion

abnormality. The patient underwent

coronary angiography via the right

femoral artery and revealed a non-

significant disease. The patient was

diagnosed with MINOCA. Treatment

given to the patient was inotropic,

antiplatelet, statin and nitrate. An ST-

segment Elevation Myocardial Infarction

(STEMI) with no obstructive coronary

artery has been a rare condition. This

case demonstrated a patient with

MINOCA in smoker men. MINOCA can

be diagnosed with coronary

angiography.

Finding the etiology of MINOCA has been a challenge. Etiology must be foundcause it can affect the therapy given to a patient with MINOCA. CardiovascularMagnetic Resonance (CMR) imaging can be used to determine the etiology andprognosis of MINOCA. Furthermore, MINOCA patient needs to do follow-up visitsto limit MACE and decrease the mortality rate.

Background

Case illustrasion and discussion

Discussion

Figure 1 ECG on ER Figure 2 ECG Day 1

Figure 3 Echocardiogram

Figure 4 Coronary Angiography