non-significant disease presenting as myocardial infarction in ......non-significant disease...
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Non-significant Disease Presenting as Myocardial Infarction in the Absent of
Obstructive Coronary Artery Disease ( MINOCA) in Men: a Case Report
A.Wicaksono 1 , R. Herdyanto2, 1Medical Intern, RSUD Sosodoro Djatikoesoemo, Bojonegoro, East Java, Indonesia; 2Department of
Cardiovascular, RSUD Sosodoro Djatikoeseomo, Bojonegoro, East Java, Indonesia.
Myocardial infarction in the absence of obstructive coronary artery disease
(MINOCA) is a variant of acute myocardial infarction (AMI) with no evidence of
obstructive coronary artery. MINOCA had been found in 8,7 % of patients with AMI.
A 44 years old male presented
with acute typical chest pain, dyspnoea,
and cold sweat after syncope, has been
smoking for 10 years with hypotension,
ST-segment elevation on limb lead II -
III, AVF, and elevated troponin I on the
second test. Echocardiography test
showed an LV regional wall motion
abnormality. The patient underwent
coronary angiography via the right
femoral artery and revealed a non-
significant disease. The patient was
diagnosed with MINOCA. Treatment
given to the patient was inotropic,
antiplatelet, statin and nitrate. An ST-
segment Elevation Myocardial Infarction
(STEMI) with no obstructive coronary
artery has been a rare condition. This
case demonstrated a patient with
MINOCA in smoker men. MINOCA can
be diagnosed with coronary
angiography.
Finding the etiology of MINOCA has been a challenge. Etiology must be foundcause it can affect the therapy given to a patient with MINOCA. CardiovascularMagnetic Resonance (CMR) imaging can be used to determine the etiology andprognosis of MINOCA. Furthermore, MINOCA patient needs to do follow-up visitsto limit MACE and decrease the mortality rate.
Background
Case illustrasion and discussion
Discussion
Figure 1 ECG on ER Figure 2 ECG Day 1
Figure 3 Echocardiogram
Figure 4 Coronary Angiography
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