Acute myocardial infarction without significant atherosclerotic lesions, an entity in constantly being updated

Abstract

Acute myocardial infarction without significant atherosclerotic lesions is a dynamic pathology that has been increasing due to new diagnostic tools. Objective: To describe the clinical and epidemiological characteristics of patients with acute myocardial infarction without atherosclerotic lesions. Material and methods: Retrospective analysis of a series of patients hospitalized for acute
myocardial infarction without significant atherosclerotic lesions on coronary angiography, admitted to the coronary unit of Hospital El Carmen, Mendoza, from January 2019 to June 2021. The diagnosis followed the latest international recommendations of the American Heart Association. Results: Eight cases are presented: 5 males, mean age 57±9.7 years. The most frequent comorbidities
were current chronic smoking in 5 cases, hypertension in 4 cases, and hypothyroidism in 2 cases. The most common presentation was ST acute coronary syndrome, 4 cases. Among the definitive diagnoses, epicardial vasospasm stands out, 3 cases, although there are various causes of all types. The mean ejection fraction was 54%. All presented troponin elevation, whose mean was 1826.1± 2209 pg/ml, the mean hemoglobin concentration was 16±7 mg/dl, the mean total cholesterol was 124±36 mg/dl; in 4 patients nuclear magnetic resonance was performed and in 3 patients it was required to perform optical coherence tomography. All evolved favorably and were discharged. Conclusions: Acute myocardial infarction without significant atherosclerotic lesions is a rare
entity, which can present both as acute coronary syndrome with or without ST-segment elevation, and it usually maintains a preserved ejection fraction and in most of them it is necessary to perform a study of greater complexity to reach the definitive specific diagnosis.