Abstract
Abstract 3118: An Unusual Case Of Severe Multivessel Atherosclerotic Coronary Artery Disease In A Very Young Patient
Arteriosclerosis, thrombosis, and vascular biology, Vol.44(Suppl_1), pp.A3118-A3118
05/2024
DOI: 10.1161/atvb.44.suppl_1.3118
Abstract
Abstract only
Introduction:
Premature coronary artery disease (CAD) is defined as CAD prior to the age of 55 for men and 65 for women, while CAD in young is defined as age <45 years. In the last decade, incidence of global premature CAD has increased by 25 %.
Case presentation:
A 20-year-old female with medical history of dyslipidemia, hypertension, type 1 diabetes mellitus and family history of premature coronary artery disease presented to the emergency room with chief complaint of chest pain and shortness of breath. EKG revealed sinus tachycardia and poor R-wave progression on anterior precordial leads. Serum troponin trend was unremarkable. Echocardiogram revealed severely reduced left ventricular (LV) ejection fraction of 20-25% with global LV hypokinesis, trace mitral and tricuspid regurgitation. Given new onset cardiomyopathy and family history of premature CAD, CT heart with coronary calcium scoring was performed which was concerning for severe LAD disease. Surprisingly, coronary angiogram revealed severe atherosclerotic disease in LAD, left circumflex and right coronary artery territories. Patient was started on guideline directed medical therapy for cardiomyopathy and has been referred to tertiary center for surgical revascularization.
Discussion:
To our best knowledge only one case has been reported before in the literature when a 21-year-old male patient had multivessel CAD requiring surgical revascularization. However, we report a case, which will be the youngest ever to have severe multivessel CAD needing surgical revascularization in the future. Cole et al, in a study of 800 young patients with CAD at long term follow up of 15 years, showed an overall mortality rate of 30 %, with 83% mortality rate in patients with EF< 30%, thus carrying a poor long-term prognosis.(2) Hence, an early initiation of treatment, including both medical therapy and revascularization should strongly be considered in these young patient population.
Conclusion:
With the increasing prevalence of premature CAD and associated risk factors, age alone should not be taken as a reliable indicator for risk stratifying patients. Emphasizing awareness among young adults with high risk of CAD that primary prevention and early lifestyle modification are of paramount importance.
Details
- Title: Subtitle
- Abstract 3118: An Unusual Case Of Severe Multivessel Atherosclerotic Coronary Artery Disease In A Very Young Patient
- Creators
- Priyanka Singh - United Health ServicesAfsha Aurshina - United Health ServicesVarun Rajagopalan - United Health ServicesZainab Imtiaz - United Health ServicesMuhammad Khan - United Health ServicesSomto Nwaedozie - Marshfield ClinicRasha Aurshiya - United Health ServicesOwais Ahmed - United Health ServicesHisham Kashou - United Health Services
- Resource Type
- Abstract
- Publication Details
- Arteriosclerosis, thrombosis, and vascular biology, Vol.44(Suppl_1), pp.A3118-A3118
- DOI
- 10.1161/atvb.44.suppl_1.3118
- ISSN
- 1079-5642
- eISSN
- 1524-4636
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Language
- English
- Date published
- 05/2024
- Academic Unit
- Internal Medicine; Hospital Medicine
- Record Identifier
- 9984945908202771
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