Abstract
Acute myocardial infarction (AMI) is rare in young adults. The management of these patients is considered as a clinical challenge. We report the case of a 26-year-old man who was presented to the Emergency Room of Affiliated Hospital of Guilin Medical University with an acute onset of chest pain. Initially electrocardiogram (ECG) with no evidence of ST-segment abnormalities but QT prolongation a signal of sudden cardiac death, 20 minutes later, it revealed ST-segment elevation myocardial infarction (STEMI). Coronary angiography (CAG) demonstrated left main coronary artery occlusion. AMI was diagnosed based on clinical symptom, elevated cardiac biomarkers, electrocardiographic dynamic monitoring and CAG. The awareness of chest pain as possible underlying AMI symptom—especially in young patients presenting with QT prolongation—is crucial for clinical treatment, as a missed diagnosis can worsen the patient’s further prognosis. In addition, reperfusion arrhythmia is a challenge to short-term outcomes of young patients with AMI, so it is necessary to make preoperative risk stratification.
Highlights
Myocardial infarction (MI) is formed when there is complete interruption of blood flow to an area of myocardium
Electrocardiogram (ECG) with no evidence of ST-segment abnormalities but QT prolongation a signal of sudden cardiac death, 20 minutes later, it revealed ST-segment elevation myocardial infarction (STEMI)
Acute myocardial infarction (AMI) was diagnosed based on clinical symptom, elevated cardiac biomarkers, electrocardiographic dynamic monitoring and Coronary angiography (CAG)
Summary
Myocardial infarction (MI) is formed when there is complete interruption of blood flow to an area of myocardium. It involves necrosis of cardiac muscle followed by inflammatory cell infiltration and, because cardiac myocytes cannot regenerate eventual fibrous repair. Significant ST-segment/T-wave changes or left bundle branch block, the development of pathological Q waves, regional myocardium wall motion abnormality, should be highly suspected of having MI. On this basis, the plasma of cTn more than the 99th percentile normal reference limit is the key to diagnosing MI. Electrocardiogram (ECG) as a basis noninvasive examination for diagnosis MI, ST-T wave criteria including: (1) New ST elevation at the J point in two contiguous leads with the cut-points: ≥0.1 mV in all leads other than leads V2 - V3 where the following cut points apply: ≥0.2 mV in men ≥40 yr; ≥0.25 mV in men 1
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