Myocardial infarction in young people with normal coronary arteries

Editor,—Williams and colleagues1 recently described two patients in their early 20s presenting with acute myocardial infarction (AMI) in whom subsequent invasive investigation demonstrated no evidence of atheromatous coronary disease. In their review of the pathogenesis of AMI in patients with “normal” coronary arteries, alcohol and cocaine are discussed as potential triggers for coronary spasm or local thrombus, but …