Table 1.

Diagnostic criteria for myocardial infarction with non-obstructive coronary artherosclerosis and vasospastic angina

MINOCA diagnostic criteria elements
1	AMI criteria, including:
	(a) Positive cardiac biomarker: defined as a rise and/or fall in serial levels, with at least one value above the 99th percentile upper reference limit and
	(b) Corroborative clinical evidence of infarction, including any of the following:
	– i. Ischaemic symptoms (chest pain and/or dyspnoea)
	– ii. Ischaemic ECG changes (new ST-segment changes or LBBB)
	– iii. New pathological Q waves
	– iv. New loss of viable myocardium on myocardial perfusion imaging or new RWMA
	– v. Intracoronary thrombus evident on angiography or at autopsy
2	Absence of obstructive CAD on angiography (defined as no lesions ≥50%)
3	No clinically apparent cause for the acute presentation
Vasospastic angina diagnostic criteria elements
1	Nitrate-responsive angina—during spontaneous episode, with at least one of the following:
	(a) Rest angina—especially between night and early morning
	(b) Marked diurnal variation in exercise tolerance—reduced in morning
	(c) Hyperventilation can precipitate an episode
	(d) Calcium channel blockers (but not beta-blockers) suppress episodes
2	Transient ischaemic ECG changes—during spontaneous episode, including any of the following in at least two contiguous leads:
	(a) ST-segment elevation ≥0.1 mV
	(b) ST-segment depression ≥0.1 mV
	(c) New negative U waves
3	Coronary artery spasm—defined as transient total or subtotal coronary artery occlusion (>90% constriction) with angina and ischaemic ECG changes either spontaneously or in response to a provocative stimulus (typically acetylcholine, ergonovine or hyperventilation)

AMI acute myocardial infarction, CAD coronary artery disease, ECG electrocardiogram, LBBB left bundle branch block, RWMA regional wall motion abnormality