Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) Revealing Polycythemia Vera: A Case Report

Introduction: Acute myocardial infraction typically associated with atherosclerosis and coronary lesions, can occur without significant stenosis, implicating microcirculatory obstruction.

Case Presentation: We present a case of a 60-year-old woman with hypertension and atrial fibrillation who was admitted with chest pain. Initially diagnosis of high-risk NSTEMI, but coronary angiography showed no significant lesions. Cardiac MRI revealed myocardial necrosis, indicating myocardial infraction with non-obstructive coronary arteries (MINOCA). Further investigation identified polycythemia vera as the cause. The patient was transferred to the hematology department and discharged with DAPT, atorvastatin, and bisoprolol.

Conclusion: The case presented illustrates the importance of recognizing polycythemia vera as an important cause of thrombosis, not only of MI with significant coronary lesion, but also of MI with non-obstructive coronary arteries.