TP-NOCA

Today Linda brought us a striking case of Troponin Positive Non-obstructive Coronary Artery Myocarditis. Some learning points from Linda:

  • When facing the syndrome of MINOCA (MI w/nonobstructive coronary arteries) or TP-NOCA (troponin-positive nonobstructive coronary arteries), consider cardiac MRI to evaluate for myocarditis. The classic pattern on MR is patchy delayed gadolinium enhancement of the myocardium
  • Three distinct groups of myocarditis- idiopathic, viral, and inflammatory
  • Presentations of acute myocarditis with chest pain or dysrhythmia have higher rates (as high as 50%) of spontaneous remission.