What is the clinical evidence from this study?

Study design: Case Report. Population: Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) (n=1). Intervention: Medical treatment. Primary outcome: Plaque erosion and stenosis assessment.

What question did this study set out to answer?

This case report aims to explore plaque erosion as a potential cause of MINOCA in a young male patient.

February 2, 2026Srce i krvni sudovi0 citationsOpen Access

MINOCA caused by plaque erosion

Q: What does this research mean for the field?

Plaque erosion is a significant cause of MINOCA, as demonstrated in a case where a patient showed improvement with medical treatment and no recurrence of symptoms over two years. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

MČMilenko Čanković DDDragana Dabović NKNikola Komazec

Key Result

The patient with MINOCA caused by plaque erosion showed significant improvement with medical treatment and no recurrence of symptoms over two years.

Key Points

This case report aims to explore plaque erosion as a potential cause of MINOCA in a young male patient.
Case study of a 32-year-old male with chest pain and elevated cardiac enzymes.
Urgent coronary angiography and OCT performed to assess coronary blockage and plaque characteristics.
Follow-up imaging with CT coronarography after two years to monitor stenosis progression.
Non-significant 30% stenosis found via coronary angiography in proximal LAD.
OCT revealed plaque erosion and a white thrombus mass; initial lumen area measured at 7.91mm2.
Functional tests showed no ischemia one year post-incident, and 25% stenosis noted after two years.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

A 32-year-old male patient presenting with acute myocardial infarction with nonobstructive coronary arteries (MINOCA) caused by plaque erosion.

Intervention

Medical treatment guided by optical coherence tomography (OCT) findings.

Outcome

Clinical symptoms and functional tests for ischemia.

Multimodal intracoronary imaging such as OCT is vital in MINOCA patients to identify underlying mechanisms like plaque erosion and guide appropriate medical management.

Limitations

Single case report; conclusions may not be generalizable to larger populations.

Abstract

Introduction. According to clinical studies, the prevalence of acute myocardial infraction with nonobstructive coronary arteries (MINOCA) is around 5%. MINOCA can be triggered by various atherosclerotic and nonatherosclerotic causes with heterogenous pathophysiological mechanisms. Plaque disruption is frequent at MINOCA patients and it implies plaque rupture, plaque erosion, and calcium node. We presented a case of a 32-year-old male patient with MINOCA caused by plaque erosion. Case report. A 32-year-old male patient was admitted due to chest pain, ECG abnormalities, and elevated cardio specific enzymes. Urgent coronary angiography was performed and non-significant 30% stenosis was found in proximal LAD. OCT was performed in LAD revealing plaque erosion with white thrombus masses, as well as a 57% stenosis, with minimal lumen area of 7.91mm2 . According to OCT findings, it was decided to proceed with medical treatment. During follow-up, the patient was without symptoms. Functional tests on ischemia were normal after one year of the incident. After two years of the incident, CT coronarography registered a mild 25% stenosis in the proximal LAD. Conclusion. In the diagnostics and treatment of the patients with MINOCA, it is vital to use a multimodal imaging. Plaque erosion is one of the possible causes of MINOCA, firstly because of the possibility to trigger vasospasm with consequential impaired flow. The usage of intracoronary imaging is paramount to adequately analyze the morphology in the culprit area.

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