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Recurrent myocardial infarction with angina and normal coronary arteries
Insights
Patients with recurrent myocardial infarctions and angina may have normal coronary arteries. Coronary artery spasm and diminished coronary reserve are potential factors in these cases.
Area of Science:
- Cardiology
- Cardiovascular Research
Background:
- Ischemic heart disease (IHD) can present with normal coronary arteries on angiography.
- While some IHD patients experience angina pectoris, a smaller group presents with myocardial infarction (MI).
- Recurrent MIs and angina with normal coronary arteries are infrequently reported.
Abstract:
Although it is well recognised that patients with ischemic heart disease can have normal coronary arteries on coronary angiography, most such patients have angina pectoris, whilst a minority have had a previous myocardial infarction. There are few reports of patients with recurrent myocardial infarctions and angina, but with normal coronary arteries on coronary angiography. We describe six patients who had more than one myocardial infarction, confirmed by raised cardiac enzymes and changes on the electrocardiogram. They subsequently developed classical angina and subsequent coronary angiography demonstrated no atherosclerotic coronary artery disease. Coronary artery spasm and diminished coronary reserve may have been contributory factors in these patients.