To the editor:A 44-year-old man was admitted because of metastatic lower abdominal pain.He had a history of acute chest pain and progressively increased troponin that occurred 13 years ago.A coronary angiogram performed at the time of chest pain showed normal coronary arteries.The patient quit smoking and received warfarin therapy for two years.On admission,measurement of cardiac enzymes revealed no evidence of acute myocardial infarction.