# Hypercortisolism with coronary nonobstructive myocardial infarction and left ventricular noncompaction: a case report

## TL;DR

A 40-year-old woman with no visible heart blockage had a heart attack linked to high cortisol levels and a rare heart condition.

## Contribution

This case highlights a rare connection between hypercortisolism, MINOCA, and left ventricular noncompaction.

## Key findings

- The patient had acute myocardial infarction without obstructive coronary disease.
- Hypercortisolism and left adrenal cortex adenoma were identified as potential causes.
- Left ventricular noncompaction was detected during follow-up cardiac MRI.

## Abstract

This study reported a 40-year-old female patient admitted to hospital for acute myocardial infarction. Emergency coronary angiography showed no obvious vascular stenosis or occlusion, but radionuclide myocardial perfusion imaging suggested myocardial ischemia. Combined with the results of myocardial injury markers, the patient was diagnosed with MINOCA. In the process of further searching for the potential cause of MINOCA, she was found to have hypercortisolism with left adrenal cortex adenoma. Cardiac magnetic resonance performed during follow-up not only confirmed the anatomical location of the previous infarction but also suggested the concomitant presence of left ventricular noncompaction. This study provides a unique perspective to explore the complex interaction between endocrine dysfunction and myocardial injury, and also highlights the complexity of etiology and diagnostic challenges of MINOCA.