Acute Coronary Syndrome in Well Trained Young Adult: A Rare Cases
Versions
- 2020-09-19 (2)
- 2020-09-19 (1)
Downloads
Acute Coronary Syndrome (ACS) has been observed in the older population (>40 years old), sedentary lifestyle and unhealthy behavior. Recently, there is an increase of ACS reported in the younger population even without a sedentary lifestyle. We report a case of a well-trained 25-years old man that came with late presentation of ST elevation myocardial infarction (STEMI) occurred 10 minutes after vigorous exercise. His traditional risk factor was a smoker. Electrocardiogram (ECG) showed a pathological Q wave in anteroseptal lead and T wave inversion in anterior lead with elevated cardiac biomarker. Primary percutaneous coronary intervention (PPCI) was performed due to prolonged chest pain and it showed subtotal occlusion in mid left anterior descending artery (LAD) with high thrombus burden. Drug eluting stent (DES) was implanted at mid LAD and GPIIb/IIIa inhibitor and low molecule weight heparin was given with good clinical result.
Fabian Sanchis-Gomar, Carme Perez-Quilis. Epidemiology of coronary heart disease and acute coronary syndrome. Annal of Transisional Medicine, 2016 May: 4 (13): 256
Aram J. Mirza, Abdulsalam Y Taha, Bahar R Khdir. Risk Factors for Acute Coronary Syndrome in Patient Below The Age of 40 years. Egyp Heart J. 2018 Dec;70(4):233-235
Thompson PD, Franklin BA, Balady GJ, Blair SN, Corrado D, Estes III NMet al. Exercise and acute cardiovascular events: placing the risks into perspective: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation. 2007 May 1;115(17):2358-68.
Esteban M, Montero S, Sánchez J, Hernández H, Pérez J, Afonso J et al. Acute Coronary Syndrome in the Young: Clinical Characteristics, Risk Factors and Prognosis. The Open Cardiovascular Medicine Journal. 2014;8(1):61-67.
Eijsvogels T, Molossi S, Lee D, Emery M, Thompson P. Exercise at the Extremes. Journal of the American College of Cardiology. 2016;67(3):316-329.
Foster C, Porcari J, Battista R, Udermann B, Wright G, Lucia A. The Risk in Exercise Training. American Journal of Lifestyle Medicine. 2008;2(4):279-284.
Katrina L Piercy. Richard P Troiano. Rachel M Ballard. 2018. Benefits and Risks Associated with Physical Activity, American College of Sport Medicine Position Stand on the Quantity and Quality of Exercise. 2008. American College of Sport Medicine. 2018 Nov 20;320(19):2020-2028
Ainsworth, BE et al. Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011; 43(8): 1575-81
Maron BJ, Shirani J, Poliac LC, Mathenge R, Roberts WC, Mueller FO. Sudden death in young competitive athletes: clinical, demographic, and pathological profiles. JAMA. 1996; 276: 199–204.
U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. Washington, DC: U.S. Department of Health and Human Services; 2018 : 55-68
Haskell WL , Lee IM , Pate RR , et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association . Med Sci Sports Exerc .2007 ; 39 ( 8 ): 1423 – 34 .
von Klot S, Mittleman M, Dockery D, Heier M, Meisinger C, Hormann A et al. Intensity of physical exertion and triggering of myocardial infarction: a case-crossover study. European Heart Journal. 2008;29(15):1881-1888.
Gordon JB, Ganz P, Nabel EG, Fish RD, Zebede J, Mudge GH, Alexander RW, Selwyn AP. Atherosclerosis influences the vasomotor response of epicardial coronary arteries to exercise. J Clin Invest. 1989; 83: 1946–1952.
Davies MJ, Bland JM, Hangartner JR, Angelini A, Thomas AC. Factors influencing the presence or absence of acute coronary artery thrombi in sudden ischaemic death. Eur Heart J. 1989; 10: 203–208.
Hoberg E, Schuler G, Kunze B, Obermoser AL, Hauer K, Mautner HP, Schlierf G, Kubler W. Silent myocardial ischemia as a potential link between lack of premonitoring symptoms and increased risk of cardiac arrest during physical stress. Am J Cardiol. 1990; 65: 583–589.
La Gerche A, Burns A.T., Mooney D.J., et.al., Exercise-induced right ventricular dysfunction and structural remodelling in endurance athletes. Eur Heart J, 2012 Apr; 33(8):998-1006.
Fernandes T, Soci UP, Oliveira EM. Eccentric and concentric cardiac hypertrophy induced by exercise training: microRNAs and molecular determinants. Brazilian Journal of Medical and Biological Research. 2011 Sep;44(9):836-47
McArdle W. D., Katch F.I., Katch V.L., The cardiovascular system and exercise. In Essentials of exercise physiology 2006; 3rd ed., 353-354
Baylin A, Hernandez-Diaz S, Siles X, Kabagambe EK, Campos H. Triggers of nonfatal myocardial infarction in Costa Rica: heavy physical exertion, sexual activity, and infection. Annals of epidemiology. 2007 Feb 1;17(2):112-8.
Schoenenberger AW, Radovanovic D, Stauffer JC, Windecker S, Urban P, Niedermaier G, Keller PF, Gutzwiller F et al. Acute coronary syndromes in young patients: presentation, treatment and outcome. International journal of cardiology. 2011 May 5;148(3):300-
Pitsavos C, Panagiotakos DB, Chrysohoou C, Skoumas J, Tzioumis K, Stefanadis C et al. Association between exposure to environmental tobacco smoke and the development of acute coronary syndromes: the CARDIO2000 case–control study. Tobacco control. 2002 Sep 1;11(3):220-5
Ogawa K, Tanaka T, Nagoshi T, Sekiyama H, Arase S, Minai K et al. Increase in the oxidised low-density lipoprotein level by smoking and the possible inhibitory effect of statin therapy in patients with cardiovascular disease: a retrospective study. BMJ open. 2015 Jan 1;5(1)
Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular disease: an update. Journal of the American college of cardiology. 2004 May 19;43(10):1731-7
Copyright (c) 2020 Aprila Aqmarina Indah, Praditya Virza Ramadhan, Vireza Pratama, Haikal Haikal, Irnizarifka Irnizarifka
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
- Cardiovascular and Cardiometabolic Journal (CCJ) is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License
-
Authors who publish with Cardiovascular and Cardiometabolic Journal (CCJ) agree to the following terms:
-
The journal allows the author to hold the copyright of the article without restrictions.
-
The journal allows the author(s) to retain publishing rights without restrictions.
-
The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution ShareAlike 4.0 International License (CC BY-SA).
