Guidelines for the management of myocardial infarction/injury with non-obstructive coronary arteries (MINOCA): a position paper from the Dutch ACS working group

T. F. S. Pustjens, Y. Appelman, P. Damman, J. M. ten Berg, J. W. Jukema, R. J. de Winter, W. R. P. Agema, M. L. J. van der Wielen, F. Arslan, S. Rasoul, A. W. J. van ’t Hof

Research output: Contribution to journalReview articleAcademicpeer-review


Patients with myocardial infarction and non-obstructive coronary arteries (MINOCA), defined as angiographic stenosis <50%, represent a conundrum given the many potential underlying aetiologies. Possible causes of MINOCA can be subdivided into coronary, myocardial and non-cardiac disorders. MINOCA is found in up to 14% of patients presenting with an acute coronary syndrome. Clinical outcomes including mortality, and functional and psychosocial status, are comparable to those of patients with myocardial infarction and obstructive coronary arteries. However, many uncertainties remain regarding the definition, clinical features and management of these patients. This position paper of the Dutch ACS working group of the Netherlands Society of Cardiology aims to stress the importance of considering MINOCA as a dynamic working diagnosis and to guide the clinician in the management of patients with MINOCA by proposing a clinical diagnostic algorithm.
Original languageEnglish
Pages (from-to)116-130
Number of pages15
JournalNetherlands Heart Journal
Issue number3
Early online date22 Nov 2019
Publication statusPublished - 1 Mar 2020

Cite this