Myocardial infarction (MI) with normal coronary arteries (MINOCA) and ischemia with normal coronary arteries (INOCA) are syndromes characterized by evidence of myocardial necrosis or myocardial ischemia, respectively, without obstructive atherosclerotic disease of the epicardial coronary arteries on angiography. As syndromes, MINOCA and INOCA are characterized by a collection of clinical findings that occur together, but they encompass a range of pathophysiologic conditions. As Muhammed et al. highlight in a comprehensive review in this issue of the European Journal of Internal Medicine (1), MINOCA can be caused by coronary microvascular dysfunction (CMD), coronary vasospasm, atherosclerotic plaque rupture or disruption, spontaneous coronary artery dissection, hypertrophic cardiomyopathy, aortic stenosis, and atrial tachyarrythmias.
