[Acute myocardial infarction with normal coronary angiography: a 46-cases descriptive study]

Abstract

This a retrospective study on 46 patients conducted over a 9-year period. These patients had an acute myocardial infarctus (AMI) confirmed wilth changes on the electrocardiogram and raised cardiac enzymes. However, the subsequent coronary angiography showed normal in all these patients. The purpose of our study is to assess epidemiologic, clinical, pronostic and therapeutic features of AMI with angiographically normal coronary arteries and compare the results obtained with those of AMI with coronary artery disease. AMI with angiographically normal coronary arteries is a first coronary event in young patients (mean age 47.7 years) having few coronary risk factors (54.3% have only one risk factor) mainly smoking (73.9%). The anterior location is prevalent. The patients with AMI and angiographically normal coronary arteries have a better prognosis than those with coronary artery stenosis. Indeed, their left ventricular function is unaltered (mean ejection fraction 48.7%). Hypokinesis is the most frequent abnormality of wall motion noticed. The patients' post infarction course is bengin when the coronary arteries are angiographically normal. The incidence of hemodynamic complications and ischemic recurrences are lower than in AMI with coronary stenosis. The choice treatment remains fibrinolysis.