Iuliano Luigi, Micheletta Fausta, Napoli Alessandro, Catalano Carlo
Department of Internal Medicine, Unit of Vascular Medicine, Sapienza University of Rome, Corso della Repubblica, 04100 Latina, Rome, Italy.
J Med Case Rep. 2009 Jan 23;3:24. doi: 10.1186/1752-1947-3-24.
Although 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.
We 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.
This 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.
虽然急性心肌梗死通常与阻塞性冠状动脉疾病相关，但与正常冠状动脉相关的心肌梗死也是一种已知的情况。正常冠状动脉心肌梗死的总体患病率被认为较低，根据“正常”冠状动脉的定义，患病率在1%至12%之间。
我们在此描述一例49岁女性，有既往心肌梗死病史，在10年随访期间持续无症状，且不存在不良结局的高危因素。对她进行了多层冠状动脉计算机断层扫描和全身血管造影，结果显示冠状动脉和冠状动脉外血管均正常。
本病例报告提出了两个重要问题。第一，多层计算机断层扫描/冠状动脉造影在已知或疑似冠状动脉疾病患者的风险和预后评估中的可能作用。第二，长期药物治疗在既往心肌梗死且冠状动脉正常的患者中所起的重要作用。
