Death from myocardial infarction after exercise test with normal result.

Death from acute myocardial infarction immediately followed a submaximal exercise test with a normal result in a 56-year-old man. Hemorrhage into an intimal atherosclerotic plaque with superimposed, intraluminal clot formation was the cause of coronary artery occlusion. It is probable that the exercise precipitated an intramural capillary rupture and intimal hemorrhage or caused further hemorrhage into a preexisting intimal hematoma. The resulting luminal narrowing and intimal rupture with superimposed clot formation caused coronary artery occlusion.