Is it time to drop "infarction" from MINOCA? Researchers writing in the European Heart Journal argue that swapping the "I" from "infarction" to "injury" would better reflect the condition's working diagnosis status — since only about 20–25% of MINOCA cases actually turn out to be a true myocardial infarction. The change could reduce diagnostic confusion for both clinicians and patients.
Researchers are calling for a rethink of the acronym MINOCA — myocardial infarction in the absence of obstructive coronary arteries — arguing that the "I" for "infarction" is misleading. In a viewpoint published in the European Heart Journal, Dr. Chiara Bucciarelli-Ducci and colleagues propose replacing "infarction" with "injury," arguing the current term prematurely assigns a diagnosis before the full workup is complete.
The push comes down to a simple but important reality: only around 20–25% of MINOCA cases ultimately turn out to be a true myocardial infarction. The rest involve a wide range of ischemic and nonischemic causes — from microvascular disease and Takotsubo syndrome to hypoxia, inflammation, and systemic illness. Using "injury" would keep the diagnostic door open and better align with how the condition is actually managed.
Key Takeaways
Why it matters: Diagnostic clarity isn't just semantic — it shapes treatment decisions, patient confidence, and care coordination. Experts suggest this change could eventually make its way into clinical guidelines, with similar reconsiderations potentially needed for related conditions like ANOCA and INOCA.
