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Discussion

Our patient fulfills the diagnosis of MI with non-obstructive coronary arteries (MINOCA)–defined as MI in the absence of significant coronary artery disease lesion (> 50%) and clinically overt specific cause for the acute presentation. MINCOA represents 1–14% of total MI and is classified into four groups according to etiology. The fourth group is secondary to myocardial disorders without involvement of the coronary arteries as seen in HCM. CMR within 2 weeks after onset of symptoms should be considered to increase the diagnostic accuracy for identifying the etiological cause of MINOCA. Data on the outcome of MI in HCM patients compared to non-HCM patients are conflicting. However, the presence of MVO in our patient is a poor prognostic sign.

Conclusion: Hypertrophic cardiomyopathy is a possible underlying etiology of MINOCA. To the best of our knowledge, MVO in the setting of HCM presenting …