Contemporary approach to st elevation myocardial infarction in very young

B''lgarska kardiologiia Pub Date : 2023-09-25 DOI:10.3897/bgcardio.29.e107056

R.P. Yalamanchi, R. Showkathali, A.М. Kumar, P. Kannan

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Abstract

Coronary artery disease (CAD) commonly occurs in individuals over the age of 45 years. Several studies categorize “young” individuals with CAD or acute myocardial infarction as those below the ages of 40 and 45. The protection provided by young age has slowly been eroded by risk factors like smoking, obesity, and sedentary lifestyle that are becoming more common among young individuals. We report a case of 21-year-old male with family history of premature coronary artery disease, who presented with acute anterior wall ST elevation myocardial infarction. Coronary angiogram revealed 100% thrombotic occlusion of proximal left anterior descending coronary artery. Further evaluation of the lesion morphology using optical coherence tomography revealed plaque erosion. Thrombolysis in Myocardial Infarction coronary grade III flow was achieved after thrombus aspiration. Stent deployment was deferred to avoid the need for lifelong medication and its associated side effects in a young patient. Due to their anti-thrombotic qualities, we also recommend using novel oral anticoagulants in this situation for short-term therapy.

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非常年轻的st抬高型心肌梗死的现代治疗方法

冠状动脉疾病(CAD)常见于45岁以上的个体。一些研究将“年轻”分类为“年轻”。年龄在40岁和45岁以下的冠心病或急性心肌梗死患者。年轻所提供的保护已经慢慢地被吸烟、肥胖和久坐不动的生活方式等风险因素所侵蚀，这些风险因素在年轻人中变得越来越普遍。我们报告一例21岁男性，有早发性冠状动脉疾病家族史，表现为急性前壁ST段抬高型心肌梗死。冠状动脉造影显示左冠状动脉前降支近端100%血栓闭塞。使用光学相干断层扫描进一步评估病变形态，发现斑块侵蚀。心肌梗死的冠状动脉III级血流在血栓抽吸后实现溶栓。为了避免年轻患者终身用药及其相关副作用，支架部署被推迟。由于其抗血栓特性，我们也建议在这种情况下使用新型口服抗凝剂作为短期治疗。

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