Clinical analysis of acute myocardial infarction in emergency normal coronary angiography

Objective To investigate the clinical symptoms and pathogeny of acute myocardial infarction(AMI) in emergency normal coronary angiography(CAG). Methods From October 2015 to October 2017, the clinical data of 207 AMI patients withemergency CAG in the First People's Hospital of Huainan were retrospectively analyzed, including 7 patients with normal CAG.The clinical symptoms and pathogeny of these patients were analyzed. Results Among the patients with AMI, the patients with normal CAG accounted for 3.38 %(7/207), the average age was (49.00±11.94)years old, 4 patients were men, 3 patients were smokers and 3 patients had hypertension.The results of laboratory examination were cTnI (7.81±4.32)μg/L, myoglobin (231.43±136.03)μg/L, CK-MB (15.3±4.63)μg/L.The pathogeny of these patients were one case with coronarospasm(14.29 %), one case with myocardial bridge(14.29%), two cases with intracoronary thrombolysis(28.57%), two cases with aortic dissection (28.57%), and one case with myocarditis(14.29%). In addition to aortic dissection in 1 case of death, 1 case was transferred outside, the rest of the patients discharged after hospitalization. Conclusion AMI mainly occurres because of vascular thrombosis caused by the unstable coronary atherosclerosis plaque rupture, but some patients with normal CAG can also occure AMI, it has different clinical characteristics and pathogenys.In practice it should be carefully identified in order to improve the cure rate and prognosis. Key words: Myocardial infarction; Coronary occlusion; Myocardial bridging; Autolysis of coronary artery thrombosis; Aortic aneurysm, thoracic; Coronary angiography; Emergency treatment