Posted on Jun 10, 2018, 1 a.m.
A new category of heart attack which is not caused by obstructed arteries is more common and higher risk than was previously thought, especially among women, as published in the International Journal of Cardiology.
36,000 patients were followed within a 12 year interval and it was found that close to 6% have had a heart attack without blockage in the arteries. This is the first study to look at the myocardial infarction with nonobstructive coronary arteries which was launched after seeing an increase in MINOCA patients, to gain better understandings of the less understood heart attack causes.
Myocardial infarction with nonobstructive coronary arteries cases have been seen as a benign condition with patients being sent home without any treatment or lifestyle advice. It has been found that after a one year period 5% of myocardial infarction with nonobstructive coronary arteries patients either had another heart attack or had died of another heart attack. Findings are eye opening as patients with clogged coronary artery have 9% chance of repeat of death within a year.
Myocardial infarction with nonobstructive coronary arteries prognosis has been found to worsen with time, after 5 years 11% of MINOCA patients are likely to have a repeat or die compared to 16% of patients with blocked arteries; and that patients were twice as likely to be female. 25% of common heart attack patients are female, 50% of MINOCA patients are female.
Plaque ruptures or blockages are not seen leading physicians to downplay the event and provide limited information sending patients home being told not to worry. Many MINOCA known causes do not respond to targeted therapies. Only 40% of the MINOCA patients were provided with suitable medications that could potentially reduce risk of repeat or death in this study.
Patients and doctors need to be made aware that this is a real condition associated with adverse outcomes, more in depth probes need to be conducted by physicians regarding patient information about the condition to prevent a second heart attack including making important healthier lifestyle changes.
The myocardial infarction with nonobstructive coronary arteries condition was recognized in the guidelines by the European Society of Cardiology for major heart attacks.
Women appear to be more susceptible to a group of heart attacks not related to blocked arteries, it is not clear why. Potential causes of myocardial infarction with nonobstructive coronary arteries are being investigated identifying: tiny ruptures or tears in the artery which are not visible without specialized equipment; small amounts of plaque build up and clots not visible during coronary angiograms; inflammation of heart muscle; and stress induced heart muscle dysfunction.
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