MINOCA Heart Attack: The Silent Threat Affecting Women, Demanding New Guidelines

• MINOCA is a unique heart attack type where major arteries aren't blocked, but the heart lacks blood supply, accounting for 6-10% of cases.
• More common in women and young women, it presents typical heart attack symptoms but shows no significant blockage on coronary angiography.
• Diagnosis requires advanced tests like OCT, Cardiac MRI, and Transesophageal Echo to identify underlying causes after initial angiography.
• Causes vary, including epicardial spasm (35.6%), plaque instability (22.2%), and spontaneous coronary artery dissection (13.3%), necessitating tailored treatment.
• The PROMISE trial, led by Dr. Rocco A. Montone, shows individualized treatment significantly improves outcomes and calls for updated guidelines.