Don’t Miss the Sword in the Lung: Unveiling a Previously Undiagnosed Congenital Syndrome in a Suspected Myocardial Infarction with Nonobstructive Coronary Arteries Patient

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a working diagnosis encompassing a wide spectrum of ischemic and non-ischemic conditions. We report the case of a 57-year-old male admitted for exertional chest pain and elevated troponin levels, initially managed as suspected MINOCA. Coronary angiography excluded obstructive coronary artery disease, while subsequent multimodality imaging unexpectedly revealed Scimitar syndrome, a rare congenital heart disease. This case underscores the diagnostic complexity of MINOCA and the crucial role of advanced imaging in uncovering alternative, non-ischemic etiologies.