CTICasesMyocardial infarction with clean coronaries
Imaging findings
Cardiac MRI shows a dilated left ventricle with wall thinning and transmural and subendocardial late gadolinium enhancement in the anterior wall and apex along with prominent apical trabeculation, in a patient with a history of acute chest pain, elevated troponin, and angiographically normal coronary arteries.
Key takeaways
Myocardial infarction with non-obstructive coronary arteries (MINOCA) can occur due to plaque rupture with transient thrombosis or vasospasm. On cardiac MRI, infarcted and thinned myocardium can show prominent trabeculation that mimics focal myocardial non-compaction, but the presence of territorial late gadolinium enhancement confirms an ischemic etiology.
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