Myocardial Infarction in Young Women with Normal Coronary Arteriograms

@article{Glancy1971MyocardialII,
  title={Myocardial Infarction in Young Women with Normal Coronary Arteriograms},
  author={David Luke Glancy and Melvin L. Marcus and Stephen E. Epstein},
  journal={Circulation},
  year={1971},
  volume={44},
  pages={495–502}
}
Two women, ages 34 and 36 years, suffered an acute transmural anterior myocardial infarction accompanied by typical ECG and serum enzyme changes. At the time of selective cinecoronary arteriography 29 and 57 months later, however, neither had demonstrable narrowing of any coronary artery. Both have persistent ECG changes of an anterior infarct and markedly diminished contractions of a large segment of the anterior wall and apex on left ventriculogram. Neither before nor after infarction has… 
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Postpartum myocardial infarction and coronary occlusion, when they do occur, are frequently caused by primary coronary artery dissection, and immediate recognition of this association may significantly reduce morbidity and mortality for these patients.
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TLDR
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Acute myocardial infarction with normal and near normal coronary arteries. Documentation with coronary arteriography within 12 1/2 hours of the onset of symptoms in two cases (three episodes).
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TLDR
It is recommended that all patients age 35 and under sustaining a myocardial infarction should undergo selective coronary arteriography, in order to establish prognosis.
Myocardial infarction in pregnancy associated with a coronary artery thrombus.
TLDR
The case of a 36-year-old multigravid woman in whom acute myocardial infarction developed at five months post partum is described, showing a thrombus-like lesion in the coronary artery branch supplying the area of myocardIAL damage with no other evidence of coronary artery disease.
Myocardial Infarction with Normal Coronary Arteries: The Pathologic and Clinical Perspectives
TLDR
Thrombolytics, aspirin, nitrates, and beta blockers should be instituted as a standard therapy for acute myocardial infarction and the calcium channel blockers could be added since coronary vasospasm appears to play a major role in the pathophysiology of this condition.
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