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Jan 28, 2015

Shedding Light on a Mysterious Type of Heart Attack

MINOCA is a heart attack not resulting from narrowed arteries.

Women and younger adults are more likely to suffer a rare type of heart attack that has no known cause, according to a study published in the American Heart Association’s journal, Circulation.

Research shows that nearly all heart attack patients have a serious build-up of plaque in their arteries, called obstructive coronary artery disease. These narrowed arteries can worsen over time, potentially cutting off blood flow to a section of the heart and causing a heart attack.

However, researchers have found that some patients experience heart attacks yet have no serious plaque build-up—a condition called myocardial infarction with non-obstructive coronary arteries (MINOCA). Very little is known on the subject, and there are no professional guidelines regarding the management of this mysterious condition.

For this reason, researchers reviewed the latest evidence to shed light on what causes MINOCA, who is at risk and how fatal this type of heart attack can be. A total of 28 studies were included in the review, all of which were published in peer-reviewed medical journals.

Based on all available data, researchers concluded that MINOCA accounted for 6% of all heart attacks. On average, patients suffering this type of heart attack were 55 years old. Patients with MINOCA were more likely to younger and female, yet less likely to have conditions like high cholesterol and high triglycerides. Also, patients with MINOCA had a lower risk of death in the 12 months following their heart attack compared to heart attack patients with coronary artery disease.

Findings suggest that MINOCA is not uncommon and requires further investigation to better understand the cause, diagnosis and treatment of this condition. Authors consider MINOCA to be a “working diagnosis” and with additional research, hope for the creation of formal guidelines to help improve outcomes for patients impacted by this condition.

Questions for You to Consider

  • What is the difference between obstructive and nonobstructive heart disease?
  • Coronary artery disease (also called coronary heart disease or heart disease) is a term used to describe the narrowing of the arteries inside the heart due to the build up of plaque, known as atherosclerosis. With obstructive heart disease, the build-up of plaque in the arteries can slow or stop the flow of blood to the heart. With nonobstructive heart disease, called coronary microvascular disease (MVD), there is damage to the blood vessels that branch off from the larger coronary arteries. Women develop nonobstructive heart disease more often than men and diagnosing this condition can be a challenge, since standard tests are not designed to detect this microvascular disease.

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