Abstract
IntroductionAlthough 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.Case presentationWe 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.ConclusionThis 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.
Highlights
Acute myocardial infarction is generally associated with obstructive coronary artery disease, myocardial infarction associated with normal coronary arteries is a wellknown condition
The important role played by long-term pharmacological therapy in patients with prior myocardial infarction and normal coronary arteries
We report a case of a young female patient with a previous clinically diagnosed Myocardial infarction (MI), who was asymptomatic in standard care therapy for a 10-year follow-up and has been shown to have normal coronary arteries by coronary multi-slice computed tomography (MSCT) and wholebody angiography
Summary
The estimated annual incidence of MI, new and recurrent in the US is 865 000, and among these, about 350 000 are women (11) Among these women, the above-mentioned 7% to 32% with normal coronary angiography translate into 24 500 to 112 000 women with acute MI and normal coronary arteries annually in the US alone. The above-mentioned 7% to 32% with normal coronary angiography translate into 24 500 to 112 000 women with acute MI and normal coronary arteries annually in the US alone This sub-population of patients affected by CHD is significant and the lack of randomized clinical trials, comparing therapies for the reduction of adverse cardiac events in patients with MI and normal coronary arteries, makes their management challenging. It is difficult to find a physio-pathological rationale that allows us to transfer secondary prevention guidelines from patients with established coronary artery disease to patients with normal coronary arteries
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