Coronary arterial dissection: an unrecognized cause of myocardial infarction, with subsequent coronary arterial patency.

A 55-year-old man survived an acute myocardial infarction. Coronary angiographic studies at two months after infarction demonstrated a primary dissection with stenosis of the right coronary artery. Repeat angiographic studies 19 months later showed resolution of the dissection, with the return of coronary luminal patency. This is the first angiographic description of primary coronary arterial dissection. This mechanism can cause the phenomenon of myocardial infarction without significant coronary arterial stenosis seen at subsequent coronary angiographic studies.