18 Sep 2020, 20:42
Harry Ridwan Dibaca : 416Yandi Ariffudin, Chaerul Achmad, Achmad Fauzi Yahya, Erwinanto, Pintoko Tedjokusumo, Eko Antono
Subdivision of Invasive Cardiology, Departement of Cardiovascular Medicine
Padjajaran University / Hasan Sadikin General Hospital
Myocardial Infarction in young is rare and only 2%-6% of all MI’s occur in adults under age 45 year in the presence or absence of atherosclerosis. Notably, young patient are at increased risk to be misdiagnosed since they do not frequently have traditional coronary risk factor. 1
In other side, we found in literature some cases of Myocardial Infarction with Normal Coronary Arteries (MINCA). It has been recognized that1%-2% patients may suffer MINCA.2
We found 20 year old man with chest pain and ST elevation on electrocardiogram without traditionally coronary risk factor, but marked elevation of troponins, which later led to the diagnosis of myocardial infarction. On Angiogram showd a normal coronary arteries and the echocardiogram was normal.
A healthy 20-year –old man presented to emergency department with chest pain 5 hour before admitted to Hasan Sadikin Hospital while was sleeping. The chest pain was severe, radiated to the left arm and followed with palpitation, short of breath and diaphoresis.
There was no risk factor for Coronary Artery Disease.
On physical examination, his blood pressure was 120/80 mmHg and his pulse was 80 beats/min. His heart sound were normal and there were no complication of myocardial infarction.
A 12 lead electrocardiogram showed ST segment elevation in lead I, aVL, II,III, aVF, V2-V6 and there was evolution in three day of observtion. CXR was normal. His serum creatinine kinase (CKMB) peaked at 179 (nomal
Angiogram displayed a normal coronary arteries. Echocardiogram was normal.
This patient was given Fondaparinux 1x2,5 mg s.c., Ascardia 1x80 mg p.o. and amlodipin 1x2,5 mg p.o. After three day of observation haemodinamyc were stable dan no more complaint of chest pain.
Pengirim : dr. Yandi Ariffudin