title: Acute myocardial infarction with normal coronary artery: a case report and review of literature.
abstract: A 17-year-old girl with no risk factors for coronary artery disease had acute myocardial infarction. She received thrombolytic therapy with tissue-type plasminogen activator. An extensive workup for the cause of myocardial infarction revealed protein S deficiency. Angiography showed normal coronary arteries. We speculate that the cause of myocardial infarction was coronary spasm or thrombus formation, which was successfully dissolved by thrombolytic therapy. This is the eighth case report of acute myocardial infarction in a patient with normal coronaries and protein S deficiency. We reviewed the literature concerning myocardial infarction and normal coronaries and protein S deficiency. This case report and review of the literature suggest the need to extend the concept of classic risk factors for coronary artery disease in young patients with myocardial infarction and normal coronary arteries.
authors.affiliation: Division of Cardiology, Nassau County Medical Center, East Meadow, New York 11554, USA. Manzar@pol.net
authors.forename: K J
authors.initials: KJ
authors.lastname: Manzar
authors.forename: F A
authors.initials: FA
authors.lastname: Padder
authors.forename: A R
authors.initials: AR
authors.lastname: Conrad
authors.forename: I
authors.initials: I
authors.lastname: Freeman
authors.forename: E A
authors.initials: EA
authors.lastname: Jonas
mesh_terms: D000293:Adolescent; D001777:Blood Coagulation; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D018455:Protein S Deficiency / Q000150:complications*; D012307:Risk Factors