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MINOCA Associated with a Myocardial Bridge: Pathogenesis, Diagnosis and Treatment

Myocardial bridging (MB) is the most frequent congenital coronary anomaly characterized by a segment of an epicardial coronary artery that passes through the myocardium. MB is an important cause of myocardial ischemia and is also emerging as a possible cause of myocardial infarction with non-obstruc...

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Autores principales: Rinaldi, Riccardo, Princi, Giuseppe, La Vecchia, Giulia, Bonanni, Alice, Chiariello, Giovanni Alfonso, Candreva, Alessandro, Gragnano, Felice, Calabrò, Paolo, Crea, Filippo, Montone, Rocco A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253711/
https://www.ncbi.nlm.nih.gov/pubmed/37297993
http://dx.doi.org/10.3390/jcm12113799
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author Rinaldi, Riccardo
Princi, Giuseppe
La Vecchia, Giulia
Bonanni, Alice
Chiariello, Giovanni Alfonso
Candreva, Alessandro
Gragnano, Felice
Calabrò, Paolo
Crea, Filippo
Montone, Rocco A.
author_facet Rinaldi, Riccardo
Princi, Giuseppe
La Vecchia, Giulia
Bonanni, Alice
Chiariello, Giovanni Alfonso
Candreva, Alessandro
Gragnano, Felice
Calabrò, Paolo
Crea, Filippo
Montone, Rocco A.
author_sort Rinaldi, Riccardo
collection PubMed
description Myocardial bridging (MB) is the most frequent congenital coronary anomaly characterized by a segment of an epicardial coronary artery that passes through the myocardium. MB is an important cause of myocardial ischemia and is also emerging as a possible cause of myocardial infarction with non-obstructed coronary arteries (MINOCA). There are multiple mechanisms underlying MINOCA in patients with MB (i.e., MB-mediated increased risk of epicardial or microvascular coronary spasm, atherosclerotic plaque disruption and spontaneous coronary artery dissection). The identification of the exact pathogenetic mechanism is crucial in order to establish a patient-tailored therapy. This review provides the most up-to-date evidence regarding the pathophysiology of MINOCA in patients with MB. Moreover, it focuses on the available diagnostic tools that could be implemented at the time of coronary angiography to achieve a pathophysiologic diagnosis. Finally, it focuses on the therapeutic implications associated with the different pathogenetic mechanisms of MINOCA in patients with MB.
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spelling pubmed-102537112023-06-10 MINOCA Associated with a Myocardial Bridge: Pathogenesis, Diagnosis and Treatment Rinaldi, Riccardo Princi, Giuseppe La Vecchia, Giulia Bonanni, Alice Chiariello, Giovanni Alfonso Candreva, Alessandro Gragnano, Felice Calabrò, Paolo Crea, Filippo Montone, Rocco A. J Clin Med Review Myocardial bridging (MB) is the most frequent congenital coronary anomaly characterized by a segment of an epicardial coronary artery that passes through the myocardium. MB is an important cause of myocardial ischemia and is also emerging as a possible cause of myocardial infarction with non-obstructed coronary arteries (MINOCA). There are multiple mechanisms underlying MINOCA in patients with MB (i.e., MB-mediated increased risk of epicardial or microvascular coronary spasm, atherosclerotic plaque disruption and spontaneous coronary artery dissection). The identification of the exact pathogenetic mechanism is crucial in order to establish a patient-tailored therapy. This review provides the most up-to-date evidence regarding the pathophysiology of MINOCA in patients with MB. Moreover, it focuses on the available diagnostic tools that could be implemented at the time of coronary angiography to achieve a pathophysiologic diagnosis. Finally, it focuses on the therapeutic implications associated with the different pathogenetic mechanisms of MINOCA in patients with MB. MDPI 2023-05-31 /pmc/articles/PMC10253711/ /pubmed/37297993 http://dx.doi.org/10.3390/jcm12113799 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Rinaldi, Riccardo
Princi, Giuseppe
La Vecchia, Giulia
Bonanni, Alice
Chiariello, Giovanni Alfonso
Candreva, Alessandro
Gragnano, Felice
Calabrò, Paolo
Crea, Filippo
Montone, Rocco A.
MINOCA Associated with a Myocardial Bridge: Pathogenesis, Diagnosis and Treatment
title MINOCA Associated with a Myocardial Bridge: Pathogenesis, Diagnosis and Treatment
title_full MINOCA Associated with a Myocardial Bridge: Pathogenesis, Diagnosis and Treatment
title_fullStr MINOCA Associated with a Myocardial Bridge: Pathogenesis, Diagnosis and Treatment
title_full_unstemmed MINOCA Associated with a Myocardial Bridge: Pathogenesis, Diagnosis and Treatment
title_short MINOCA Associated with a Myocardial Bridge: Pathogenesis, Diagnosis and Treatment
title_sort minoca associated with a myocardial bridge: pathogenesis, diagnosis and treatment
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253711/
https://www.ncbi.nlm.nih.gov/pubmed/37297993
http://dx.doi.org/10.3390/jcm12113799
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