A rapid and accurate diagnosis of acute ST-segment elevation myocardial infarction (STEMI) is of crucial importance as early initiation of primary percutaneous coronary intervention (PCI) is beneficial to patients.
1-3 In general, plaque rupture or plaque erosion and subsequent platelet aggregation and thrombosis resulting in acute occlusion of a coronary artery is considered the main mechanism of STEMI.
4 However, coronary arteries without any stenosis have been reported in 2.6% of patients with suspected STEMI on acute diagnostic coronary angiography (CAG).
5 Although some of these patients may actually suffer from myocardial infarction resulting merely from coronary spasm or a thrombus,
5-7 others may have alternative diseases and conditions. …