Acute myocardial infarction shortly after negative exercise test and reperfusion by intracoronary thrombolysis.

A 67-year-old man developed an acute myocardial infarction shortly after normal exercise testing. His clinical history and findings from emergency coronary arteriography suggested that coronary artery spasm followed by intraluminal thrombosis might have been responsible for the myocardial infarction. Although intracoronary thrombolysis two hours after the onset of chest pain provided continued patency of an occluded vessel, serial myocardial perfusion scintigraphies documented myocardial injury, which was probably induced by reperfusion, rather than myocardial salvage.