MYOCARDIAL INFARCTION WITH NO OBSTRUCTIVE CORONARY ARTERY DISEASE (MINOCA): CCS/CWHHA CLINICAL PRACTICE UPDATE 2023 (CCC-115)

Thursday, October 26, 2023

11:00 – 12:00 EST

Location: Palais, 515ABC

Target Audience: General: All cardiovascular (clinical and research) health professionals, Clinical cardiologists, Magnetic imaging specialist

Co-Chair(s)

Christine Pacheco, MD, MSc, FRCPC

Cardiologist
Hôpital Pierre-Boucher, Centre Hospitalier de l'Université de Montréal (CHUM)
Université de Montréal

Presenter(s)

Alexandra Bastiany, MD

Interventional Cardiology
Thunder Bay Regional Health Sciences Centre
Northern Ontario School of Medicine (NOSM)
Judy Luu, MD/PhD, FRCPC

Women's Heart Health Cardiologist, Assistant Professor
McGill University
McGill University
SM

Sharon L. Mulvagh, MD

Professor of Medicine
CSE
Dalhousie University

Planning Committee Co-Chair(s)

Thais Coutinho, MD (she/her/hers)

Chief, Division of Cardiac Prevention and Rehabilitation
University of Ottawa Heart Institute
University of Ottawa Heart Institute

Planning Committee Member(s)

Amelie Paquin, MD, MSc (she/her/hers)

Fellow
CSE
Laval University

Disclosure(s):

Christine Pacheco, MD, MSc, FRCPC: KYE pharmaceuticals: Consultant/Advisory Board (Terminated, January 6, 2022), Speaker/Honoraria (Terminated, January 6, 2022); Novartis: Other Research Support (includes receipt of drugs, supplies, equipment or other in-kind support) (Ongoing), Speaker/Honoraria (Ongoing)

Judy Luu, MD/PhD, FRCPC: No financial relationships to disclose

Sharon L. Mulvagh, MD: Lantheus Medical Imaging: Consultant/Advisory Board (Ongoing); Novo Nordisk: Consultant/Advisory Board (Ongoing)

Amelie Paquin, MD, MSc: No financial relationships to disclose

Learning Objectives / Objectifs d'apprentissage:

At the end of this session participants will be able to / Au terme de cette conférence, vous serez:

discuss pathophysiology and epidemiology of MINOCA;
demonstrate comprehension of invasive and non-invasive diagnostic algorithms of MINOCA; and
determine appropriately tailored management for patients with MINOCA.

Workshop Description: MINOCA is an encompassing heterogenous diagnosis, and when properly investigated, an underlying etiology can be identified in the majority of cases. This position statement will summarize the epidemiology, clinical presentation, diagnostic work-up, and treatment of underlying causes of MINOCA.
MINOCA disproportionately affects women, and a persistent gap in clinical care is observed for these patients, including higher mortality following myocardial infarction in younger women in Canada, recurrent angina and recurrent emergency department visits, reduced quality of life, and increased health care costs related to inaccurate diagnosis and suboptimal treatment. Unique to Canada is the availability and coverage of specific testing that is based on geographical location. The proposed position statement will provide a guide to the workup and management of MINOCA, based on level of evidence and availability of specific technologies. Furthermore, in recent years, trials concerning diagnostic testing have demonstrated the utility of advanced cardiac imaging techniques including cardiac magnetic resonance imaging and optical coherence tomography in properly diagnosing underlying causes of MINOCA. Tailored therapy in patients with microvascular angina and coronary vasospasm, often identified in patients with MINOCA, has been shown to improve outcomes. These recent trials, among others, have emerged as convincing evidence supporting a more expansive, comprehensive clinical approach to MINOCA, enhancing the need for updated societal recommendations.