Chest Pain in a Young Patient: Acute Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) Due to Extrinsic Compression Secondary to a Bronchogenic Cyst.

Acute myocardial infarction with non-obstructive coronary arteries (MINOCA) is a condition that meets the criteria for acute myocardial infarction without evidence of significant obstructive coronary artery disease on angiography.

It accounts for approximately 6–8% of infarctions evaluated with coronary angiography and more frequently affects women and young adults. Its mechanisms include non-obstructive plaque rupture, vasospasm, coronary artery dissection, microvascular dysfunction, and thromboembolic events. In rare cases, it may be associated with extrinsic compression by mediastinal masses.

A bronchogenic cyst is a congenital malformation of the mediastinum that rarely produces symptoms due to compression. We present the case of a young patient with MINOCA secondary to coronary compression by a mediastinal bronchogenic cyst, highlighting the importance of multimodal imaging and a non-atherosclerotic etiological approach in acute myocardial infarction.