Acute Myocardial Infarction in an Elderly Patient With Severe Aortic Stenosis and Angiographically Normal Coronary Arteries

SummaryAortic stenosis (AS) is common in the elderly and is associated with an increased risk of death from cardiovascular events. Nevertheless, acute myocardial infarction (AMI) in patients with severe AS and “normal” coronary arteries is very rare. We present an elderly male with severe AS and angiographically normal coronary arteries who experienced AMI. Platelet hyperaggregability, activation of blood coagulation, coronary microcirculatory dysfunction, imbalance of supply and demand in the hypertrophied myocardium, and subendocardial ischemia predisposed by AS are possible mechanisms. The relevant literature is reviewed and discussed in the report.