Myocardial infarction in the absence of coronary arteriosclerosis

Angina pectoris in patients without flow-limiting coronary artery disease (cardiac syndrome X). A forest of a variety of trees

“…These adverse outcomes are consistent with the cardiovascular continuum expected from a disorder involving the microvasculature [13,16,17,[21][22][23]. Many pathologic mechanisms may induce CAS which is a proven cause of myocardial ischemia and AP [13,21,[24][25][26][27][28][29][30] and is the 3 rd etiologic mechanism in CSX [13]. CAS is linked with some genetic background [9,10,23,24].…”

“…CAS is linked with some genetic background [9,10,23,24]. In CSX-patients CAS has been linked with an ACS in > 50% of cases [26,29,30] and was thought to be the cause of myocardial infarction in some cases [24,30,31]. In CSX-patients, CAS has been induced with acetylcholine (i.e.…”

The role of coronary thrombosis in myocardial infarction: Further evidence shown by intracoronary thrombolysis with streptokinase

“…Frequently, this finding has been attributed to prolonged coronary spasm capable of triggering the formation of a thrombus. How- ever, although coronary spasm has been documented angiographically in some cases [3,5], the presence of a spontaneously occurring thrombus on a near normal coronary artery has never been shown during angiography in man. Indeed, recent studies [I] with intracoronary thrombolysis in acute myocardial infarction have shown a high incidence of coronary thrombosis, but these thrombi were reported to be superimposed on significant coronary stenoses.…”

Myocardial Infarction with Patent Coronary Arteries

“…However, an acute spasm of the anterior descending branch of the left main coronary artery, re sponsible for the infarction, cannot be excluded as a cause for the infarct, and any infarction, irrespective of its causative factor, can give rise to a mural thrombus. It has been shown recently during coronary arteriog raphy [7,9] that such coronary spasm can occur.…”