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Revista Virtual de la Sociedad Paraguaya de Medicina Interna

On-line version ISSN 2312-3893


ALDERETE MARTINEZ, José Fernando  and  CENTURION, Osmar Antonio. Ethiopathogenesis and prognostic implication in myocardial infarction without obstruction of the epicardial coronary arteries (MINOCA). Rev. virtual Soc. Parag. Med. Int. [online]. 2020, vol.7, n.1, pp.86-95. ISSN 2312-3893.

Myocardial infarction without coronary artery obstruction (MINOCA) is a clinical syndrome characterized by clinical evidence of myocardial infarction with normal coronary arteries or with non-significant stenosis in coronary angiography equal to or less than 50%. MINOCA is a clinical syndrome with multiple etiologies that can affect both epicardial vessels and microcirculation, with a prevalence of 6%. A personalized medicine approach should be performed whereby patients with different angina subtypes, defined by the results of coronary functional tests, can benefit from an individualized and targeted therapy. A greater flow of research is required to determine if this approach can lead the patient to clinical benefits. The more generalized invasive tests allow the identification of diagnostic subgroups for the development of targeted therapies guided by mechanistic studies. The therapeutic management depends on the cause that originates it, if it becomes identified. The prognosis is variable, depending on the cause, and in many cases it is similar to those cases with coronary obstruction. The correct diagnosis of the underlying cause of angina allows the precise, specific and stratified treatment of the different types of etiological cause. This way of acting has shown that this approach is safe, feasible and with demonstrable benefits for patients with MINOCA.

Keywords : Acute myocardial infarction; MINOCA; coronary vasospasm; microcirculation..

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