J Korean Soc Echocardiogr.  1998 Dec;6(2):179-185.

Two Cases of Acute Myocardial Infarctions with Normal Coronary Arteriograms and Early Complete Recovery of Myocardial Dysfunction

• Noh JH
• Kang HS
• Choue CW
• Kim KS
• Song JS
• Bae JH

Abstract

The cases of myocardial infarction with normal coronary arteriograms are uncommon however they have been reported over many years. The common causes of these are suggested to be acute spasm or thrombus. For many years, the finding of asynergy on the echocardiography was believed to indicate the presence of infarcted myocardium or scarring. It is now clear that chronic left ventricular dysfunction in patients with coronary artery disease is not necessarily irreversible and the concept of hibernating myocardium is now regarded as the main mechanism. However the complete improvement of the motion abnormalities of myocardium is also very uncommon. Following cases are about patients with acute myocardial infarctions with abnormal EKGs, heart enzymes, and normal coronary arteriogams. The MIBI SPECT showed partial reversible abnormalities of perfusion. Their heart wall revealed akinesia at echocardiograms on admission. On the following echocardiograms 18days or 10days after onset, the akinesias that had been observed before, were disappeared completely and normal ventricular wall motions were showed. This report documents unusual cases of acute myocardial infarction with angiographycally normal coronary arteries and early complete improvement of heart wall motion abnormalities.

Keyword

Normal coronary artery; Complete recovery of myocardial dysfunction

MeSH Terms

Cicatrix
Coronary Artery Disease
Coronary Vessels
Echocardiography
Electrocardiography
Heart
Humans
Myocardial Infarction*
Myocardium
Perfusion
Spasm
Thrombosis
Tomography, Emission-Computed, Single-Photon
Ventricular Dysfunction, Left