Myocardial infarction with normal coronary arteries: a case report and review of the literature.
BACKGROUND
Although acute myocardial infarction is generally associated with obstructive coronary artery disease, myocardial infarction associated with normal coronary arteries is a well-known condition. The overall prevalence rate of myocardial infarction with normal coronary arteries is considered to be low, varying from 1% to12% depending on the definition of "normal" coronary arteries.


METHODS
We describe here a case of a 49-year-old woman with a history of prior myocardial infarction who continued to be asymptomatic after a 10-year follow-up, in the absence of a high-risk profile for adverse outcomes. She was studied with multi-slice coronary computed tomography and whole-body angiography, which showed normal coronary and extra-coronary arteries.


CONCLUSIONS
This case report raises two important issues. First, the possible role of multi-slice computed tomography/coronary angiography in the risk- and prognosis assessment of patients with known or suspected coronary artery disease. Second, the important role played by long-term pharmacological therapy in patients with prior myocardial infarction and normal coronary arteries.
Iuliano
Luigi
L
Department of Internal Medicine, Unit of Vascular Medicine, Sapienza University of Rome, Corso della Repubblica, 04100 Latina, Rome, Italy. luigi.iuliano@uniroma1.it.
Micheletta
Fausta
F
Napoli
Alessandro
A
Catalano
Carlo
C