Heart attacks are often linked to blocked arteries, but this is not always the case. Some patients experience all the signs of a heart attack, including chest pain and abnormal blood tests, yet their arteries appear normal during routine examinations. This puzzling condition is known as MINOCA.
MINOCA accounts for a significant number of heart attacks, affecting between 6% and 15% of patients. It is also more common in women, which has raised concerns about whether traditional methods of diagnosing heart disease are missing important details.
A recent international study has provided new insight into this problem. Led by researchers at NYU Grossman School of Medicine and published in Circulation, the study shows that using two advanced imaging techniques together can uncover the cause in most cases.
The research included 336 patients from multiple countries, making it one of the most comprehensive studies on this condition. Participants underwent detailed testing using two complementary methods.
The first method, OCT, allows doctors to look closely at the inside of the arteries. It can detect small changes that are not visible with standard imaging. The second method, cardiac MRI, examines the heart muscle itself and shows patterns of injury or inflammation.
By combining these approaches, researchers were able to identify the cause of the heart event in 79% of patients. This is a significant improvement compared to relying on a single test.
The results showed that many patients did have a form of heart attack related to blood flow problems, even though their arteries did not appear blocked. Others had different conditions that mimic heart attacks, such as inflammation or stress-related heart issues.
This finding changes how doctors think about heart attacks. It shows that there is not just one type of heart attack, but a range of conditions that can produce similar symptoms.
Another important discovery is that doctors cannot predict which patients will benefit from specific tests. Symptoms, blood tests, and initial scans are not enough to determine the cause. This means that a more comprehensive approach is often needed.
The study also found that once MINOCA occurs, the underlying causes are similar in both men and women. This suggests that the disease process is consistent, even if the condition is more common in women.
These findings have important implications for treatment. When doctors understand the exact cause, they can choose the most appropriate therapy. For example, treating inflammation is very different from treating a blocked artery.
However, there are challenges to consider. Advanced imaging requires specialized equipment and trained staff, which may not be available everywhere. Further research is needed to make these techniques more widely accessible and to develop clear treatment guidelines.
This study, presented at the American College of Cardiology’s Annual Scientific Session, marks an important step toward better diagnosis and care.
In conclusion, the research highlights the need to look beyond traditional explanations of heart attacks. By using advanced imaging, doctors can provide clearer answers and better treatment for patients who might otherwise be left without a diagnosis.
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Source: NYU Grossman School of Medicine.
