A 42-year-old man with recurrent myocardial infarction and normal appearing coronary arteries

We report the occurrence of a coronary mural thrombus and recurrect myocardial infarction in a patient with normal-appearing epicardial coronary arteries and small-vessel coronary artery disease. The current case emphasizes the importance of permanent medical treatment with anti-platelet and vasodilators in patients with small-vessel coronary artery disease.