Acute myocardial infarction with normal coronary arteries--viral myopericarditis and possible coronary vasospasm. A
Insights
A young man experienced a heart attack despite having normal coronary arteries. The likely cause was a combination of virus-induced myopericarditis and coronary artery vasospasm.
Area of Science:
- Cardiology
- Pathophysiology
- Medical Diagnostics
Background:
- Myocardial infarction (MI) typically occurs in the presence of coronary artery disease.
- Understanding MI in patients with normal coronary arteries is crucial for accurate diagnosis and treatment.
Observation:
- A young male patient presented with symptoms and diagnostic markers of a transmural apical myocardial infarction.
- Diagnostic workup included serial cardiac enzymes, ECG, thallium-201 exercise scanning, left ventricular angiography, and coronary arteriography.
Findings:
- Coronary arteriography revealed normal coronary arteries, ruling out obstructive coronary artery disease as the cause of infarction.
- The patient's presentation suggests a non-atherosclerotic cause for myocardial infarction.
Implications:
- This case highlights the importance of considering alternative etiologies for myocardial infarction, particularly in younger individuals.
- Virus-induced myopericarditis and coronary artery vasospasm are potential mechanisms for myocardial infarction in the absence of coronary atherosclerosis.
Abstract:
A young man with normal coronary arteries presented with a transmural apical myocardial infarction. This diagnosis was based on elevated serial cardiac enzyme values, ECG changes, exercise scanning with thallium-201, left ventricular angiography and selective coronary arteriography. Some of the pathophysiological mechanisms implicated in myocardial infarction in patients with normal coronary arteries are discussed and the probable diagnosis of a virus-induced myopericarditis together with coronary artery vasospasm is favoured.
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