Acute myocardial infarction with normal coronary arteries

Lindsay, Joseph; Pichard, Augusto D.

doi:10.1016/s0002-9149(84)80230-1

Cited by 68 publications

(31 citation statements)

References 23 publications

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“…It has been hypothesized that the probable mechanism may be temporary occlusion of the infarct related vessel by spasm or thrombus or a combination of both. In the present case, patient showed improvement in one week of treatment in the form of recovery of consciousness and at one month of follow up showed improvement in the power of the affected limbs (13)(14)(15).…”

Section: Discussionsupporting

confidence: 57%

Disulfiram Ethanol Reaction with Ischemic Stroke

Babu¹,

Shetty²,

Aiyappa³

et al. 2014

Electron J Gen Med

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Section: Discussionsupporting

confidence: 57%

Disulfiram Ethanol Reaction with Ischemic Stroke

Babu¹,

Shetty²,

Aiyappa³

et al. 2014

Electron J Gen Med

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“…[2][3][4][5][6] The pathogenesis of MI in patients with normal coronary arteries remains unknown, but is hypothesized to be temporary occlusion of the infarct-related vessel by spasm, thrombus or a combination of these. 24 In the present study, the non-FH group had a high incidence of normal and non-obstructive coronary arteries in the culprit lesion. In contrast, the FH group had a high incidence of significant stenosis and multi-vessel stenosis.…”

Section: Lesion Morphology and Pathogenesismentioning

confidence: 45%

Coronary Lesion Morphology and Prognosis in Young Males With Myocardial Infarction With or Without Familial Hypercholesterolemia

et al. 2001

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yocardial infarction (MI) is rare in young adults, 1 and its characteristics may differ from those typically seen in older patients. Several reports of coronary arteriography performed in young patients after MI have demonstrated a relatively high incidence of angiographically normal coronary arteries, and the prognosis of these patients is good. [2][3][4][5][6][7][8][9][10][11] However, familial hypercholesterolemia (FH) with high serum levels of low-density lipoprotein (LDL) cholesterol often produces premature coronary artery disease in young males, 12,13 and when MI occurs at age 30 in males with FH, the incidence of cardiovascular death is greater than among the general population. 12 However, it is unknown whether the pathophysiology and prognosis of MI in young male patients with and without FH is the same, so the present study investigated the angiographical characteristics and prognosis of this syndrome. Methods PatientsFrom 1978 to 1990, 45 consecutive male patients under the age of 40 years with their first MI who were admitted to Kanazawa University Hospital and Fukui Cardiovascular Center were enrolled in the study. Two patients who had undergone percutaneous transluminal coronary angioplasty in the acute phase were excluded, but patients treated with Japanese Circulation Journal Vol.65, April 2001 thrombolysis or conventional therapy in the acute phase were not. Sixteen patients diagnosed with FH were assigned to the FH group and 27 patients comprised the non-FH group. FH was diagnosed according to the following 2 criteria: 14 (1) primary hypercholesterolemia (arbitrary total cholesterol >230 mg/dl) with tendon xanthomas, and (2) primary hypercholesterolemia with or without tendon xanthomas in a first degree relative. The diagnosis of MI was made according to the following 3 criteria: (1) characteristic clinical history, (2) serial changes on the ECG suggesting MI (Q-waves) or injury (ST-segment elevations), and (3) transient increase in cardiac enzymes. Coronary AngiographyCoronary angiography was performed in the chronic phase (11-100 days (mean, 42) after onset). Significant coronary artery stenosis was defined as at least 75% reduction in the internal diameter of the right, left anterior descending, or left circumflex coronary arteries and their branches, or ≥50% reduction in the internal diameter of the left main trunk. Non-obstructive stenosis was defined as coronary obstruction less than a significant stenosis. Coronary arteries were considered angiographically normal if they had no appreciable stenosis. Patients with either angiographically normal coronary arteries or non-obstructive disease were classified as having zero-vessel disease. The morphologic appearance of each lesion, classified as complex or smooth, was independently assessed by 2 investigators at separate sittings using a previously described method. [16][17][18] Complex stenoses were defined by the presence of one or more of the following criteria: (1) irregular or scalloped borders, (2) abrupt lesion edges perpendicular t...

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“…Acute myocardial infarction in patients with normal coronary arteries may occur via transient occlusion of coronary vessel(s) by spasm and/or thrombus (15). Indeed, a previous case report described a case of vasospastic angina in a patient with Shoshin beriberi (16).…”

Section: Discussionmentioning

confidence: 99%