Coronary spasm, variant angina, and recurrent myocardial infarctions.

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Abstract
A 24 yr old male student had 3 myocardial infarctions, 1 prior to and 2 following the angiographic documentation of normal coronary arteries. A spontaneous episode of variant angina prompted repeat coronary angiography, during which i.v. ergonovine caused spasm of the left anterior descending coronary artery, transient ST-segment elevation and ischemic chest pain; the previously normal right coronary artery was found to be occluded proximally. This constellation of clinical and angiographic findings suggests that coronary spasm can cause acute myocardial infarction as well as variant angina.