From Exercise to Emergency - An extreme presentation of MINOCA: A Case Report

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ID: 317019
2026
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Abstract
Abstract Background Coronary artery vasospasm (CAS) is an important, yet under-recognised cause of myocardial infarction with non-obstructive coronary arteries (MINOCA), associated with significant morbidity and mortality. Case Summary A 51-year-old male presented with an out of hospital ventricular fibrillation (VF) arrest. Coronary angiography with intravascular imaging revealed unobstructed epicardial coronary arteries and cardiac magnetic resonance imaging (CMRi) demonstrated a structurally normal heart with no evidence of fibrosis or myocardial oedema. High-sensitivity troponin I was elevated, confirming acute myocardial injury consistent with a working diagnosis of MINOCA. Subsequent comprehensive coronary function testing (CFT) demonstrated significant spasm fulfilling all three COVADIS diagnostic criteria for definitive epicardial CAS, and timely endotype specific medical therapy was instituted. Discussion This case highlights the importance of considering CAS in unexplained cardiac arrest. Specific disease endotyping allows a stratified and personalised medical treatment regimen to enhance clinical outcomes and prevent recurrences.
Reference Key
openalex_W7164334638 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Aswin Babu, Ciara Kennedy, Travis Chong, Jon Spiro
Journal European Heart Journal - Case Reports
Year 2026
DOI
10.1093/ehjcr/ytag442
URL
https://doi.org/10.1093/ehjcr/ytag442
Keywords Keywords not found

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