Acute myocardial infarction with normal coronary arteries--viral myopericarditis and possible coronary vasospasm. A case report.

A young man with normal coronary arteries presented with a transmural apical myocardial infarction. This diagnosis was based on elevated serial cardiac enzyme values, ECG changes, exercise scanning with thallium-201, left ventricular angiography and selective coronary arteriography. Some of the pathophysiological mechanisms implicated in myocardial infarction in patients with normal coronary arteries are discussed and the probable diagnosis of a virus-induced myopericarditis together with coronary artery vasospasm is favoured.