Acute myocardial infarction in young patients with non-obstructive coronary arteries

is rare and has been rarely reported in the literature.  We report herein a case of an obese young

man  presented  to the emergency department  with  typical chest pain,  ischemic ECG changes,

and  elevated  cardiac troponin T concentrations,  in whom coronary angiogram revealed nearly

normal coronary arteries.  The cause of  increased troponin in this patient is not known but may

involve  microvascular  spasm,  possibly mediated  through  endothelial dysfunction  frequently

encountered  in  obese patients.  Since  these patients have been reported  to be  at  high  risk of

future coronary events,  the treatment of  obesity and  its associated coronary artery disease risk

factors should  be intensified and an adoption of  a  healthy lifestyle should  be initiated as early

as possible.v