Myocardial infarction without obstructive coronary artery disease

The present report describes five cases of transmural myocardial infarction occurring in patients without occlusive coronary artery disease or other discernible abnormalities. It is apparent from these cases and others described in the literature that such patients may present with or without angina and, in some, the clinical course will be complicated by recurrent infarction and/or significant residual myocardial dysfunction. At present the exact incidence and natural history of this syndrome is unclear. Undoubtedly the increasing application of coronary arteriography will identify many more such patients. Delineation of the genesis and the full clinical spectrum of myocardial infarction without coronary artery disease warrants further investigative attention.