An unusual type of heart attack

Ask the doctor

Published: October, 2018

Image: © patrickheagney/Getty Images

Q. Is it possible to have a heart attack even if you don't have any blockages in your heart's arteries?

A. Yes, you can. Doctors refer to heart attacks without blocked arteries as MINOCA, which stands for myocardial infarction (that is, heart attack) with non-obstructive coronary arteries. When it occurs, people may experience typical heart attack symptoms, such as chest pressure or pain in the center of the chest (or the arms, jaw, neck, or stomach) and trouble breathing. They also have elevated blood levels of a protein called troponin, a marker of heart damage that is used to diagnose a heart attack. But the next test — a special x-ray of the heart's arteries called an angiogram — shows no evidence of a significant buildup of fatty plaque blocking any of the heart's arteries.

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