In some individuals, angina coupled with symptoms consistent with development of an acute myocardial infarction occurs immediately prior to sudden collapse and death. At autopsy, however, there is no infarct and the coronary arteries are found to be patent, without significant atherosclerosis
or congenital anomalies. Death is believed to be due to transitory coronary artery spasm. The phenomenon of coronary artery spasm without anatomical narrowing of the coronary arteries in association with angina has been demonstrated angiographically and has actually been witnessed during operative procedures.11-13 Myocardial infarction secondary to coronary artery spasm induced by use of cocaine is a well recognized phenomena.
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