[Oral contraceptives and myocardial infarct]

In the light of four proven cases of myocardial infarction in patients under treatment with hormonal contraceptives, the authors point out: the sudden 'inaugural' appearance of the infarction during a therapeutic course; the appearances of the lesions on coronary arteriography; on 2 occasions a lacunar form on the proximal segment of a main coronary trunk, in one case lesions more redolent of atheroma, and in one case a completely normal vascular tree. These appearances had not changed at follow-up arteriography; the existance in 3 cases of multiple associated risk factors, especially of a mixed type of hyperlipoproteinaemia associated with tobacco consumption. The current relative frequency of coronary episodes in patients with multiple risk factors would seem to point towards caution in prescribing hormonal contraceptive treatment, especially for females of over 35 years of age.