Normal angiogram in acute coronary syndrome—preangiographic risk stratification, angiographic findings and follow-up

Cardiac MR enables diagnosis in 90% of patients with acute chest pain, elevated biomarkers and unobstructed coronary arteries

“…Potential mechanisms of myocardial infarction without relevant stenosis of the epicardial arteries include coronary vasospasm and embolism as well as thrombosis with spontaneous recanalization of the affected vessel. 27,28 LV, left ventricular. Normally distributed continuous data are expressed as mean 6 standard deviation, while non-normally distributed data are shown as median and interquartile range.…”

Troponin-positive chest pain with unobstructed coronary arteries: definitive differential diagnosis using cardiac MRI

“…Following initial medical therapy, these patients then undergo coronary angiography and revascularisation as appropriate. However, in an important proportion of these patients, historically documented at about 10% [5,6], no flow-limiting lesions are identified at the time of coronary angiography and the coronary anatomy is commonly described as ''unobstructed''. Further evaluation is therefore necessary to identify the mechanism of presentation in this cohort, particularly because many of them retain the diagnostic label of NSTEMI together with its psychological and social implications.…”

“…Up to 10% of patients referred for angiography with troponin-positive chest pain have unobstructed coronary arteries [5,6]. This cohort of patients presents a diagnostic dilemma and as a result their subsequent management is heterogeneous.…”

Angiographic Studies of Coronary Artery Disease in Dhulikhel Hospital

“…8 Our study showed that 19% of study population who had either ACS or stable angina had normal coronaries. In comparison to stable angina, normal coronaries were less frequent in ACS group.…”