Coronary-Artery Spasm and Myocardial Infarction

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Abstract
IN this issue, Vincent et al. report a tantalizing and well-documented account of a young woman who had a myocardial infarction despite angiographically normal coronary arteries.1 The sequence of events suggests that coronary spasm was the initiating factor. However, it is still possible that an embolus from the catheter could have initiated spasm, which resulted in further stasis and further clot formation. As shown in Figure 4 in their paper, the clot was seen almost immediately after the development of a transient decrease in the size of the coronary-artery lumen. This seems rather rapid for thrombus formation in a patient . . .