Rigueira, JoanaRodrigues, TAguiar-Ricardo, InêsCunha, NPlacido, RPinto, Fausto J.Almeida, Ana G.2019-11-082019-11-082019European Heart Journal - Cardiovascular Imaging, Volume 20, Issue Supplement_2, June 2019, jez1102047-2404http://hdl.handle.net/10451/40099Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2019.Background: Nowadays it is well recognized that the absence of obstructive coronary artery disease in a patient presenting with symptoms suggestive of ischemia and ST-segment alterations does not preclude an atherothrombotic etiology. CMR is an essential method for the investigation of Myocardial infarction (MI) with non obstructive coronary artery disease (MINOCA). Clinical Case: A 66 years-old female patient was referred after an episode of acute oppressive chest pain, nausea and hypersudorese, followed by syncope. She had a previous medical history of rheumatoid arthritis, under immunosuppression, occlusion of the cilioretinal artery, hypertension and dyslipidemia. On admission she was hypotensive (80/60mmHg). The ECG showed sinus rhythm and mild ST depression in V2-V3 leads, and the echocardiogram a small circumferential pericardial effusion (10mm) with signs of hemodynamic compromise. The blood tests documented a slight leukocytosis and an elevated troponin (hs-TnT 619ng/L).engMyocardial infarction, acutejournal article10.1093/ehjci/jez110