An Unusual Case of ST Elevation Myocardial Infarction in Angiographically Non-Obstructed Coronary Arteries

It is routinely believed that patients with electrocardiographic findings of ST elevation myocardial infarction (STEMI) will have evidence of obstructive coronary artery disease on coronary angiography. Although this is the situation in the majority of STEMI instances, in a small percentage of cases, patients presenting with STEMI are found to have minimal to no coronary artery blockage on subsequent angiography, termed MI with non-obstructive coronary arteries (MINOCA). MINOCA is a heterogenous entity with multiple causes, making a focused diagnostic workup important to select an appropriate treatment, with the goal to prevent a mortality similar to obstructive coronary disease. In this case, we describe a unique presentation of MINOCA, after a patient was diagnosed with STEMI.