John K, Lal A, Sharma N, ElMeligy A, Mishra AK. Presentation and outcome of myocardial infarction with non-obstructive coronary arteries in coronavirus disease 2019. World J Crit Care Med 2022; 11(3): 129-138 [PMID: 36331992 DOI: 10.5492/wjccm.v11.i3.129]
Corresponding Author of This Article
Ajay K Mishra, FACP, MBBS, MD, Assistant Professor, Postdoctoral Fellow, Department of Cardiovascular Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, MA 01608, United States. ajay.mishra@stvincenthospital.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. May 9, 2022; 11(3): 129-138 Published online May 9, 2022. doi: 10.5492/wjccm.v11.i3.129
Presentation and outcome of myocardial infarction with non-obstructive coronary arteries in coronavirus disease 2019
Kevin John, Amos Lal, Nitish Sharma, Amr ElMeligy, Ajay K Mishra
Kevin John, Department of Critical Care, Believers Church Medical College Hospital, Thiruvalla 689103, Kerala, India
Amos Lal, Division of Pulmonary & Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
Nitish Sharma, Division of Cardiology, Saint Vincent Hospital, Worcester, MA 01608, United States
Amr ElMeligy, Division of Interventional Cardiology, Saint Vincent Hospital, Worcester, MA 01608, United States
Ajay K Mishra, Department of Cardiovascular Medicine, Saint Vincent Hospital, Worcester, MA 01608, United States
Author contributions: John K and Mishra AK contributed to the conceptual design of the study; John K and Mishra AK independently screened the articles and extracted the data; John K, Mishra AK, and Lal A contributed to the write-up and submission of the study; Mishra AK and Lal A reviewed the final manuscript; All authors reviewed and agreed with the final content of the article.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ajay K Mishra, FACP, MBBS, MD, Assistant Professor, Postdoctoral Fellow, Department of Cardiovascular Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, MA 01608, United States. ajay.mishra@stvincenthospital.com
Received: January 11, 2022 Peer-review started: January 11, 2022 First decision: February 8, 2022 Revised: April 1, 2022 Accepted: April 22, 2022 Article in press: April 22, 2022 Published online: May 9, 2022 Processing time: 116 Days and 4.6 Hours
Abstract
Among the cardiac complications of coronavirus disease 2019 (COVID-19), one increasingly reported in the literature is myocardial infarction with non-obstructive coronaries (MINOCA). We reviewed all reported cases of MINOCA in COVID-19 patients to summarize its clinical features, evaluation, and treatment. We performed a literature search in Pubmed using the search terms ‘COVID-19’ and ‘MINOCA’ or ‘non-obstructive coronaries’. Among the reported cases, the mean age was 61.5 years (SD ± 13.4), and 50% were men. Chest pain was the presenting symptom in five patients (62.5%), and hypertension was the most common comorbidity (62.5%). ST-elevation was seen in most patients (87.5%), and the overall mortality rate was 37.5%. MINOCA in COVID-19 is an entity with a broad differential diagnosis. Therefore, a uniform algorithm is needed in its evaluation to ensure timely diagnosis and management.
Core Tip: Myocardial infarction with non-obstructive coronary arteries (MINOCA) may be more commonly seen in patients with coronavirus disease 2019 (COVID-19). To ensure that cases of MINOCA are identified and managed appropriately, a well-defined, algorithmic approach should be taken while evaluating COVID-19 patients with evidence of myocardial injury. This review summarizes the clinical characteristics and outcomes of all COVID-19 patients with MINOCA reported to date.
