A Challenging and Unexpected Case of MINOCA Using Multimodality Imaging

Matthew G L Williams; Charlotte Thompson; Thomas W Johnson; Chiara Bucciarelli-Ducci

doi:10.1016/j.jaccas.2020.05.105

A Challenging and Unexpected Case of MINOCA Using Multimodality Imaging

JACC Case Rep. 2020 Aug 19;2(10):1564-1569. doi: 10.1016/j.jaccas.2020.05.105. eCollection 2020 Aug.

Authors

Matthew G L Williams^{1

2}, Charlotte Thompson^{1

2}, Thomas W Johnson¹, Chiara Bucciarelli-Ducci^{1

2

3}

Affiliations

¹ Department of Cardiology, Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom.
² Bristol Medical School, University of Bristol, Bristol, United Kingdom.
³ Bristol National Institute of Health Research (NIHR) Biomedical Research Centre, University Hospitals Bristol NHS Trust and University of Bristol, Bristol, United Kingdom.

Abstract

We describe a challenging case of a patient with MINOCA due to isolated right ventricular myocardial infarction with microvascular obstruction identified on cardiac magnetic resonance imaging. This case highlights that even a comprehensive, guideline-based assessment of these patients can initially fail to detect the underlying pathology. (Level of Difficulty: Beginner.).

Keywords: CMR, cardiac magnetic resonance; CRP, C-reactive protein; CTPA, computed tomography pulmonary angiogram; ECG, electrocardiogram; LAD, left anterior descending; LGE, late gadolinium enhancement; MINOCA, myocardial infarction with nonobstructive coronary arteries; MVO, microvascular obstruction; OCT, optical coherence tomography; RV, right ventricle; cardiac magnetic resonance; coronary angiography; myocardial infarction; right ventricle.

Publication types

Case Reports