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Article
February 14, 1994

Myocardial Infarction With Angiographically Normal Coronary Arteries: A Personal Perspective

Author Affiliations

University of Arizona Health Science Center 1501 N Campbell Ave Tucson, AZ 85724

Arch Intern Med. 1994;154(3):245. doi:10.1001/archinte.1994.00420030023003

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Abstract

PATIENTS WITH myocardial infarction and angiographically normal coronary arteries (MINC) have interested me since I was a fellow in cardiology, approximately 20 years ago. I have always felt that there must be a clue in such patients, if only it could be deduced, to the trigger that initiates acute infarction. Recently, having suffered just such an infarct, my interest was heightened further.

In this issue of the ARCHIVES, I review the literature as well as my own academic and clinical experience with this entity, particularly in light of recently discovered concepts in the areas of pathophysiology of acute myocardial infarction and vascular biology. During my recuperation, thoughts of two types occurred to me regarding MINC. My first thoughts concerned the pathophysiology of the event that had just happened to me: how could such an event occur in an individual with minimal coronary risk factors? Many of my friends and colleagues

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