TY - JOUR T1 - MINOCA: a heterogenous group of conditions associated with myocardial damage JF - Heart JO - Heart SP - 1458 LP - 1464 DO - 10.1136/heartjnl-2020-318269 VL - 107 IS - 18 AU - Trisha Singh AU - Andrew R Chapman AU - Marc R Dweck AU - Nicholas L Mills AU - David E Newby Y1 - 2021/09/01 UR - http://heart.bmj.com/content/107/18/1458.abstract N2 - Myocardial infarction with non-obstructive coronary arteries (MINOCA) was first described over 80 years ago. The term has been widely and inconsistently used in clinical practice, influencing various aspects of disease classification, investigation and management. MINOCA encompasses a heterogenous group of conditions that include both atherosclerotic and non-atherosclerotic disease resulting in myocardial damage that is not due to obstructive coronary artery disease. In many ways, it is a term that describes a moment in the diagnostic pathway of the patient and is arguably not a diagnosis. Central to the definition is also the distinction between myocardial infarction and injury. The universal definition of myocardial infarction distinguishes acute myocardial infarction, including those with MINOCA, from other causes of myocardial injury by the presence of clinical evidence of ischaemia. However, these ischaemic features are often non-specific causing diagnostic confusion, and can create difficulties for patient management and follow-up. The purpose of this review is to summarise our current understanding of MINOCA and highlight important issues relating to the diagnosis, investigation and management of patients with MINOCA. ER -