Is there a difference between an NSTEMI and a MINOCA?

[Tos92]

Good evening.

I have recently come back from a trip to Dubai where I was able to consult with my cardiologist who treated me last year at the time of my NSTEMI (non-st elevation myocardial infarction) . Despite my diagnosis reports saying I had an NSTEMI, he mentioned in the recent meeting with him that I had a MINOCA (myocardial infarction in non-obstructed coronary arteries) as a result of my coronary artery spasm. Is there a significant difference between the two, or are these terms used interchangeably?

[Milkfairy Heart Star]

NSTEMI Non ST elevation myocardial Infarction

MINOCA

Myocardial Infarction non obstructive coronary arteries.

A NSTEMI is usually caused by obstructive coronary artery disease, a permanent blockage and possible treatment are stents to open up the blockage and medication.

A MINOCA causes about 10% of heart attacks. Usually caused by non obstructive coronary artery disease. Treatment depends on the underlying cause.

Main causes are vasomotor disorders of the coronary blood vessels eg. microvascular dysfunction, coronary vasospasms.

Or spontaneous coronary artery dissection SCAD, a blood clot or a piece of plaque blocking a coronary artery.

During a MINOCA a patient can have ST elevations or ST depressions on their ECGs.

MINOCAs occur more commonly in women.

Here's some further information about MINOCAs which you may find helpful.

icrjournal.com/articles/wha...

acc.org/latest-in-cardiolog...

Other causes of ECG changes and raised troponin levels can be Takostubo syndrome or inflammation due to myocarditis.

So a NSTEMI is not the same as a MINOCA.

[Milkfairy Heart Star]

"An NSTEMI can be caused by plaque build-up (obstructive) or by arterial spasm,"

As someone who lives with vasospastic angina due to coronary vasospasms, I am afraid my Cardiologist wouldn't agree with you.

Coronary vasospasms can and do cause ST elevations, I know I have documented evidence to show my ST elevations, my coronary arteries are unobstructed.

It's possible to have a ST elevation myocardial Infarction STEMI without obstructed coronary arteries, a MINOCA.

There's nothing like the lived experience 😊.

16 admissions and counting.....

bhf.org.uk/informationsuppo...

ecrjournal.com/articles/mi-...

[Milkfairy Heart Star]

The forum guidelines suggest we share our lived experience of our particular heart conditions.

Have you experienced a MINOCA or any of the underlying possible causes?

There's nothing like being an expert by experience rather than by a Google search?

Perhaps a time for a dignified silence?

[fishonabike]

the Balearic Islands might get upset about that!😉😁

[Smitty1956]

Not trying to butt in, but the response to you did seem a bit harsh. I found your explanation helpful. My “lived experience” was with having a Non-STEMI heart attack.