Causes of MINOCA

Mnemonic 'CLEAN VASE' to aid you to remember the causes of MI with nonobstructive coronary atherosclerosis

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A new syndrome of myocardial infarction�(MI) has been defined in the clinical context over the past few years�- myocardial infarction with non-obstructive coronary arteries�(MINOCA). Causes for MINOCA can be plaque rupture, erosion and calcific nodules. Other common causes are vasospasm, coronary thrombosis or embolism, or spontaneous coronary artery�dissection. Myocardial Infarction in Critical Illness Insurance The definition for MI in the context of Critical Illness�(CI) insurance products differs from the clinical approach. The contrasting insurance industry aim is to focus on heart attacks with serious and permanent health�consequences. Most heart attack definitions define MI as death of heart muscle in a limited area due to inadequate blood supply following an occlusion or partial blockage or narrowing of coronary arteries. Additional criteria are mostly typical clinical symptoms of MI; new characteristic ECG changes and the transient increase of cardiac biomarker blood levels. Newer definitions furthermore demand a permanent reduction of the heart function, such as reduced left ventricular ejection fraction or significant and persistent wall motion�abnormalities. In comparison with AMI-CAD patients, MINOCA patients can present ST-segment elevation in an ECG, but they are less likely to have deviations. They can also show an increase of troponin blood levels. Usually the increase is less pronounced than with obstructive CAD�patients.

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