Acute alcohol intoxication and cigarette smoking may trigger extensive anterior myocardial infarction in young men with angiographically normal coronary arteries.
Case Report (n=2)
Acute myocardial infarction should be considered in young patients presenting with severe chest pain after alcohol intoxication, even with normal coronary arteries, to ensure prompt reperfusion therapy.
Myocardial infarction occurring in young people with angiographically normal coronary arteries is well described but the pathophysiology of this condition remains unknown. Coronary artery spasm in association with thrombus formation and minimal atheromatous disease or spontaneous coronary artery dissection are possible causes. Two young men presented with severe chest pain after acute alcohol intoxication and each sustained an extensive anterior myocardial infarction. Investigations including intravascular ultrasound showed no evidence of atherosclerotic coronary artery disease. Coronary artery spasm associated with acute alcohol intoxication as well as prothrombotic state and endothelial damage related to cigarette smoking may be mechanisms leading to acute myocardial infarction in these cases. Acute myocardial infarction occurs in young persons with normal coronary arteries and the diagnosis should be considered in young patients presenting with severe chest pain, particularly those abusing cocaine or alcohol, so that reperfusion therapy can be initiated promptly.
Williams et al. (Sun,) conducted a case report in Myocardial infarction with normal coronary arteries (n=2). Acute alcohol intoxication and cigarette smoking was evaluated on Extensive anterior myocardial infarction. Acute alcohol intoxication and cigarette smoking may trigger extensive anterior myocardial infarction in young men with angiographically normal coronary arteries.