Acute myocardial infarction with angiographically demonstrated normal coronary arteries in the presence of hypertrophic cardiomyopathy.

A 51-year-old black woman with known, echocardiographically-documented hypertrophic cardiomyopathy was admitted to the hospital with an acute myocardial infarction diagnosed by both electrocardiographic and serum enzyme changes. Six weeks following discharge, the patient underwent left-sided heart catheterization, left ventriculography, and coronary arteriography, and she was found to have entirely normal coronary arteries. There are possible pathogenetic mechanisms of myocardial infarction in the presence of normal coronary arteries in patients with hypertrophic cardiomyopathy, and it is also possibly significant that myocardial infarction is seen in patients with hypertropic cardiomyopathy.