Myocardial infarction with normal or near normal coronary arteries: Late outcome of seven patients Myocardial infarction with normal or near normal coronary arteries probably results from thrombotic occlusion that is followed by lysis and recanalization; in about a third of affected patients, coronary spasm appears to be the trigger. The clinical profile of this syndrome is well known: patients are young and without coronary risk factors except cigarette smoking, and they have no angina before or after their infarction. However, the late prognosis remains controversial. Between December 1976 and April 1984, myocardial infarction with normal or near normal coronary arteries was diagnosed in seven patients who were subsequently followed for a mean of 19 years. Observations during this follow-up show that the majority of patients experienced one or more recurrences that, in three cases, initiated the development of a severe ischemic cardiomyopathy.