…clinical concept Myocardial infarction with non obstructive coronary arteries (MINOCA) describes a clinical presentation in which the patient has symptoms suggestive of acute coronary syndrome…

…70% of women compared with 30–50% of men. Microvascular angina (MVA) is myocardial ischaemia caused by structural or functional abnormalities of the coronary microcirculation…

…a white, platelet rich thrombus. Myocardial vulnerability, largely driven by coronary microvascular dysfunction, also contributes to the extension and severity of ischemic injury. In its…

…of stress myocardial blood flow to resting myocardial blood flow. It provides an integrated measure influenced by epicardial stenosis, diffuse atherosclerosis, and coronary microvascular dysfunction…

…also by the vulnerability of the myocardium and coronary microcirculation. Endothelial dysfunction promotes leukocyte and platelet activation and interaction. Thrombotic debris may worsen microvascular obstruction…

…Mechanisms involving reduced myocardial perfusion include fixed coronary atherosclerosis without plaque rupture, coronary artery spasm, coronary microvascular dysfunction (encompassing endothelial dysfunction, smooth muscle cell dysfunction…

…Mechanism or clinical setting Examples Acute coronary atherothrombosis Plaque disruption or erosion with thrombosis Reduced myocardial perfusion Coronary spasm, microvascular dysfunction, coronary embolism, coronary dissection…

…ventricular failure. Mechanisms of Shock The central consequence of extensive infarction is loss of contractile myocardium, with reduced cardiac output and systemic hypoperfusion. LV failure…

…obstruction. In patients with anginal symptoms and unobstructed or non obstructive coronary arteries, possible mechanisms include microvascular obstruction, endothelial dysfunction and epicardial coronary spasm. The…

…induced angina or ischaemia associated with obstructive epicardial coronary disease. Angina or ischaemia caused by epicardial vasomotor dysfunction or microvascular abnormalities without obstructive epicardial disease…