The European Society of Cardiology (ESC) has reported criteria for a myocardial infarction with non-obstructive coronary arteries (MINOCA). The authors are from multiple institutions in Europe.
Criteria for the diagnosis of MINOCA:
(1) evidence of acute myocardial infarction (AMI)
(2) non-obstructive coronary arteries on angiography (no coronary artery with stenosis >= 50% in any potential infarct-related artery)
(3) no clinically overt specific cause for the acute presentation (excluding the presence of thrombus)
Evidence for AMI - both of the following:
(1) positive cardiac biomarker (cardiac-specific serum troponin risen then fallen, with maximum value above the 99th percentile upper reference limit)
(2) one or more of the following:
(2a) symptoms of cardiac ischemia
(2b) new significant ST-T segment changes or new LBBB
(2c) pathological Q waves
(2d) imaging evidence (new loss of viable myocardium, regional wall motion abnormality)
(2e) intracoronary thrombus
A person diagnosed with MINOCA should be evaluated for possible underlying causes (myocarditis, coronary artery spasm, etc).
