A review of diagnosis, etiology, assessment, and management of patients with myocardial infarction in the absence of obstructive coronary artery disease

Hosp Pract (1995). 2021 Feb;49(1):12-21. doi: 10.1080/21548331.2020.1817459. Epub 2020 Sep 16.


Myocardial infarction (MI) in the absence of obstructive coronary artery disease (MINOCA) is prevalent in around 5% of acute myocardial infarction (AMI) presentations. MINOCA is a heterogeneous entity with many different etiologies. It is important for health care providers to familiarize themselves with the disease process, presentation, and possible underlying causes in order to guide appropriate management strategies. In this article, the authors review the contemporary definition, etiologies and assessment, and management for AMI patients with MINOCA.

Keywords: Myocardial infarction; coronary vasospasm; nonobstructive coronary artery disease; obstructive coronary artery disease.

Publication types

  • Review

MeSH terms

  • Aortic Dissection / complications
  • Cardiomyopathy, Hypertrophic / complications
  • Cardiovascular Agents / therapeutic use
  • Coronary Artery Disease / pathology
  • Coronary Circulation / physiology
  • Coronary Vasospasm / complications
  • Coronary Vessels / pathology
  • Humans
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / drug therapy
  • Myocardial Infarction / etiology
  • Myocardial Infarction / physiopathology*
  • Myocarditis / complications
  • Platelet Aggregation Inhibitors / therapeutic use
  • Risk Factors
  • Severity of Illness Index
  • Takotsubo Cardiomyopathy / complications
  • Thromboembolism / complications


  • Cardiovascular Agents
  • Platelet Aggregation Inhibitors