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Magnetic resonance imaging of MINOCA in underlying non-ischemic dilated cardiomyopathy: a case report

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a syndrome of diverse etiology and unclear pathogenesis, with an incidence of 5-15% and varying prognosis. Cardiac magnetic resonance imaging (MRI) is playing an increasing role in the diagnosis of MINOCA and in distinguishing the causes that led to it, while being at the same time an important predictor of prognosis in these patients. We present a 40-year-old man with clinical, laboratory and instrumental data for acute coronary syndrome complicated by acute heart failure. The invasive assessment ruled out obstructive coronary heart disease as well as Takotsubo cardiomyopathy. MINOCA and myocarditis were discussed in the differential diagnostic plan. To differentiate them, cardiac MRI was performed, which confi rmed the diagnosis of „myocardial infarction with non-obstructive coronary arteries“.