Acute myocardial infarction in the presence of normal coronaries and the absence of risk factors in a young, lifelong regular exerciser

Gregory Whyte, Richard Godfrey, Rory O'Hanlon, Mathew Wilson, John Buckley, Sanjay Sharma

Research output: Contribution to journalComment/debate

6 Citations (Scopus)


Around 6% of patients suffering an acute myocardial infarction (AMI) have normal coronary arteries. The mechanisms responsible are not fully known, but include hypercoagulable state, coronary endothelial dysfunction, aortic dissection, inflammation, coronary thrombosis, aortic wall stiffening, cocaine abuse, carbon monoxide poisoning and paradoxical embolism. Here, the case of a lifelong regular exerciser without risk factors for cardiovascular disease who suffered an AMI with normal coronaries is reported. Despite normal cardiac f unction on left ventriculography and echocardiography, late gadolinium enhancement by cardiac magnetic resonance (CMR) revealed significant cardiac necrosis. The long-term prognosis is favourable with low rates of coronary morbidity and mortality. Acute chest pain should not be considered as benign and warrants medical investigation.

Original languageEnglish
Article number0384
Pages (from-to)1-8
Number of pages8
JournalBMJ Case Reports
Publication statusPublished - May 2009
Externally publishedYes


Cite this