Nonatherosclerotic causes account for about 5% of acute myocardial infarctions and include diverse etiologies such as vasculitis, infections, and substance abuse.
Clinicians should consider nonatherosclerotic causes in AMI evaluation; review leaves open optimal diagnostic and management strategies.
Approximately 5% of patients with acute myocardial infarction do not have atherosclerotic coronary artery disease but have other causes for their luminal narrowing. The third part of this three‐part review of nonatherosclerotic causes of coronary narrowing focuses on coronary vasculitis, infectious diseases, Kawasaki's disease, metabolic disorders, metastatic disease, and substance abuse (cocaine). coronary arteritis: (1) focal artery necrosis with or without calcification, (2) acute coronary artery thrombosis or recanal‐ized thrombus unassociated with underlying atherosclerotic plaque, (3) rupture of the vessel wall unassociated with trauma or an interventional procedure, (4) coronary artery wall thickening with secondary luminal narrowing, and (5) wall thinning with aneurysm formation. 3 Specific coronary lesions also may be seen in specific systemic diseases (e.g., pol‐yarteritis nodosa).
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Waller et al. (1996) studied this question.
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