title: Myocardial infarction and normal coronary arteries: the experience of the cardiology department of Sfax, Tunisia.
abstract: OBJECTIVE
  The purpose of the present study is to describe our experience with patients who have a transmural myocardial infarction (MI) in the presence of a normal coronary artery. The clinical profile, demographic characteristics and outcomes of these patients are discussed.
  
  
  METHODS
  Between January 2006 and August 2011, 21 patients who presented with a Q-wave myocardial infarction were found to have normal coronary arteries. The prevalence rate of this entity was 1.5% (21 out of 1,400 Q wave MI patients). These patients were characterized by their young age (the mean age=44.95±14.86), male dominance (90.47%), and a high prevalence of smoking (85.71%). In this study, 4 patients have an evident spontaneous spasm shown on coronary angiography which disappeared after intracoronary injection of nitrates. Coagulation Disorders, such as activated protein C resistance (APC) resistance, protein C deficiency and antiphospholipid antibody syndrome were found in 4 of 12 patients who underwent systematic examination. One patient had a history of lung cancer which may be associated with a hypercoagulable state and may explain the occurrence of myocardial infarction with a normal coronary artery. The mean left ventricle ejection was 56. 5±12. The mean follow-up was 24±10 months. Six patients developed residual chest pain which was generally easily controlled by anti-spastic therapy and no patient had a major cardiovascular event.
  
  
  CONCLUSIONS
  Patients with Q-wave MI and with normal coronary arteries seem to have a good short and long-term prognosis especially when they are treated with an exclusive medical strategy.
authors.affiliation: Department of Cardiology, Hedi Chaker Hospital, Tunisia. leilaabidt@yahoo.fr
authors.forename: Leila
authors.initials: L
authors.lastname: Abid
authors.forename: Amine
authors.initials: A
authors.lastname: Bahloul
authors.forename: Zied
authors.initials: Z
authors.lastname: Frikha
authors.forename: Souad
authors.initials: S
authors.lastname: Mallek
authors.forename: Dorra
authors.initials: D
authors.lastname: Abid
authors.forename: Malek
authors.initials: M
authors.lastname: Akrout
authors.forename: Mourad
authors.initials: M
authors.lastname: Hentati
authors.forename: Samir
authors.initials: S
authors.lastname: Kammoun
mesh_terms: D000328:Adult; D000368:Aged; D001778:Blood Coagulation Disorders / Q000150:complications; D016507:Cardiology Service, Hospital; D003329:Coronary Vasospasm / Q000150:complications; D003331:Coronary Vessels / Q000473:pathology*; D004562:Electrocardiography; D004617:Embolism / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D009369:Neoplasms / Q000150:complications; D011379:Prognosis; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects; D014416:Tunisia / Q000453:epidemiology