We present the case of a 25 years old patient who was submitted to our unit with a first time acute coronary syndrome. Despite his young age he had multiple cardiovascular risk factors. Although the chest pain was atypical and the electrocardiogram on presentation had unspecific changes, repeated investigations established the diagnosis of anterolateral myocardial infarction. Per primam angioplasty with stent implantation in the proximal segment of left anterior descending artery was performed, with good clinical outcome. Awareness is the key in establishing the diagnosis of myocardial infarction in young patients.
1. Jernberg T, Hasvold P, Henriksson M, Hjelm H, Thuresson M, Janzon M. Cardiovascular risk in post-myocardial infarction patients: nationwide real world data demonstrate the importance of a long-term perspective. European heart journal. 2015 Jan 13;36(19):1163-70.
2. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS medicine. 2006 Nov 28;3(11):e442.
3. Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe: epidemiological update. European heart journal. 2013 Sep 7;34(39):3028-34.
4. Azar RR. Coronary heart disease and myocardial infarction in young men and women. In: UpToDate, Verheught, F (Ed), UpToDate, (Accessed on February 11, 2018).
5. Razaghani A, Hafeez-Ul-Hassanvirk. Triple Vessel Coronary Artery Disease in Young Female. GJMR. 2014;14(5):1-5.
6. Singh A, Collins B, Qamar A, Gupta A, Fatima A, Divakaran S, Klein J, Hainer J, Jarolim P, Shah RV, Nasir K. Study of young patients with myocardial infarction: Design and rationale of the YOUNG‐MI Registry. Clinical cardiology. 2017 Nov 1;40(11):955-61.
7. Roth GA, Huffman MD, Moran AE, Feigin V, Mensah GA, Naghavi M, et al. Global and regional patterns in cardiovascular mortality from 1990 to 2013. Circulation. 2015;132(17):1667-78.
8. Gupta A, Wang Y, Spertus JA, Geda M, Lorenze N, Nkonde-Price C, et al. Trends in acute myocardial infarction in young patients and differences by sex and race, 2001 to 2010. J Am Coll Cardiol. 2014;64(4):337-45.
9. Goff DC, Jr., Lloyd-Jones DM, Bennett G, Coady S, D’Agostino RB, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S49-73.
10. Canto JG, Rogers WJ, Goldberg RJ, Peterson ED, Wenger NK, Vaccarino V, et al. Association of age and sex with myocardial infarction symptom presentation and inhospital mortality. JAMA. 2012;307(8):813-22.
11. Mann DM, Woodward M, Muntner P, Falzon L, Kronish I. Predictors of nonadherence to statins: a systematic review and metaanalysis. Annals of Pharmacotherapy. 2010;44(9):1410-21.
12. Yeh RW, Sidney S, Chandra M, Sorel M, Selby JV, Go AS. Population trends in the incidence and outcomes of acute myocardial infarction. N Engl J Med. 2010;362(23):2155-65.
13. Fournier JA, Sanchez A, Quero J, Fernandez-Cortacero JA, Gonzalez-Barrero A. Myocardial infarction in men aged 40 years or less: a prospective clinical-angiographic study. Clin Cardiol. 1996;19(8):631-6.
14. Doughty M, Mehta R, Bruckman D, Das S, Karavite D, Tsai T, et al. Acute myocardial infarction in the young--The University of Michigan experience. Am Heart J. 2002;143(1):56-62.
15. Greenland P, Reicher-Reiss H, Goldbourt U, Behar S. In-hospital and 1-year mortality in 1,524 women after myocardial infarction. Comparison with 4,315 men. Circulation. 1991;83(2):484-91.
16. Chouhan L, Hajar HA, Pomposiello JC. Comparison of thrombolytic therapy for acute myocardial infarction in patients aged < 35 and > 55 years. Am J Cardiol. 1993;71(2):157-9.
17. Hoit BD, Gilpin EA, Henning H, Maisel AA, Dittrich H, Carlisle J, et al. Myocardial infarction in young patients: an analysis by age subsets. Circulation. 1986;74(4):712-21.
18. al-Koubaisy OK, Mehdi RS, Arem FD, Ahmed IT. Cine angiographic findings in young Iraqi men with first acute myocardial infarction. Cathet Cardiovasc Diagn. 1990;19(2):87-90.
19. Cole JH, Miller JI, 3rd, Sperling LS, Weintraub WS. Long-term follow-up of coronary artery disease presenting in young adults. J Am Coll Cardiol. 2003;41(4):521-8.
20. Bao W, Srinivasan SR, Wattigney WA, Berenson GS. The relation of parental cardiovascular disease to risk factors in children and young adults. The Bogalusa Heart Study. Circulation. 1995;91(2):365-71.
21. Chen L, Chester M, Kaski JC. Clinical factors and angiographic features associated with premature coronary artery disease. Chest. 1995;108(2):364-9.
22. Zimmerman FH, Cameron A, Fisher LD, Ng G. Myocardial infarction in young adults: angiographic characterization, risk factors and prognosis (Coronary Artery Surgery Study Registry). J Am Coll Cardiol. 1995;26(3):654-61.
23. Akosah KO, Schaper A, Cogbill C, Schoenfeld P. Preventing myocardial infarction in the young adult in the first place: how do the National Cholesterol Education Panel III guidelines perform? J Am Coll Cardiol. 2003;41(9):1475-9.
24. Sarda L, Colin P, Boccara F, Daou D, Lebtahi R, Faraggi M, et al. Myocarditis in patients with clinical presentation of myocardial infarction and normal coronary angiograms. J Am Coll Cardiol. 2001;37(3):786-92.
25. Karjalainen J, Heikkila J. Incidence of three presentations of acute myocarditis in young men in military service. A 20-year experience. Eur Heart J. 1999;20(15):1120-5.
26. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevationThe Task Force for the management of acute myocardial infarction in patients presenting with STsegment elevation of the European Society of Cardiology (ESC). European Heart Journal. 2018;39(2):119-77.
27. Wolfe CM, Vacek JL. Myocardial infarction in the young: angiographic features and risk factor analysis of patients with myocardial infarction at or before the age of 35 years. Chest. 1988 Nov 1;94(5):926-30.