ISCHEMIC HEART DISEASE: Edited by Peter H. StoneMyocardial infarction with nonobstructive coronary arteries: the need for precision medicineDel Buono, Marco Giuseppea; La Vecchia, Giuliaa; Rinaldi, Riccardoa; Sanna, Tommasoa,b; Crea, Filippoa,b; Montone, Rocco Antoniob Author Information aDepartment of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart bDepartment of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy Correspondence to Marco Giuseppe Del Buono, MD, Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli, 1, Rome 00168, Italy. Tel: +630154432; e-mail: [email protected] Current Opinion in Cardiology: November 2022 - Volume 37 - Issue 6 - p 481-487 doi: 10.1097/HCO.0000000000000998 Buy Metrics Abstract Purpose of review Myocardial infarction with nonobstructive coronary arteries (MINOCA) represents about 6–8% of all patients with myocardial infarction (MI), and several pathophysiological mechanisms showed to be involved in this heterogeneous clinical condition. Of note, MINOCA proved to be associated with a significant risk of mortality, angina burden and socioeconomic costs. Recent findings Results from randomized clinical trials evaluating the clinical effectiveness of a comprehensive diagnostic algorithm, along with the acute and long-term management of patients with MINOCA, are pending. Summary In this review article, we aim at providing an overview of the clinical features, diagnostic work-up and the therapeutic management of patients presenting with MINOCA, highlighting the recent acquisition along with the remaining important knowledge gaps in this field. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.