Sikandar Billal H, Butler Scott, Battula Anusha, Shetty Rajendra
Internal Medicine, University of Maryland Capital Region Medical Center, Largo, USA.
Cardiology, University of Maryland Medical Center, Baltimore, USA.
Cureus. 2021 May 28;13(5):e15302. doi: 10.7759/cureus.15302.
Acute ST-elevation myocardial infarction (STEMI) is rarely seen in young adults, however, when encountered, the underlying cause is either a genetic condition leading to early-onset coronary artery disease (CAD), an acquired pro-thrombotic condition, or an idiopathic condition like spontaneous coronary artery dissection (SCAD). Our case describes a healthy 23-year-old female who presented with sudden onset severe angina and was found to have a laminated thrombus in the left anterior descending coronary artery (LAD), with no evidence of intraluminal dissection or plaque rupture. Although the underlying etiology of thrombus formation remains unknown, coronavirus disease 2019 (COVID-19) related thrombotic event is the prime suspect. In addition, another culprit that cannot be excluded is phentermine-induced coronary vasospasm, a commercially available medication for weight loss. This report addresses current literature on acute coronary syndromes in young adults and reviews the potential etiologies for coronary artery thrombosis, which led to a near-fatal acute coronary syndrome in our patient.
急性ST段抬高型心肌梗死（STEMI）在年轻人中很少见，然而，一旦发生，其潜在原因要么是导致早发性冠状动脉疾病（CAD）的遗传疾病、获得性促血栓形成疾病，要么是自发性冠状动脉夹层（SCAD）等特发性疾病。我们的病例描述了一名23岁健康女性，她突然出现严重心绞痛，被发现左前降支冠状动脉（LAD）有分层血栓，没有腔内夹层或斑块破裂的证据。尽管血栓形成的潜在病因尚不清楚，但2019冠状病毒病（COVID-19）相关血栓事件是主要怀疑对象。此外，另一个不能排除的罪魁祸首是苯丁胺引起的冠状动脉痉挛，苯丁胺是一种市售的减肥药物。本报告阐述了有关年轻人急性冠状动脉综合征的当前文献，并回顾了导致我们患者发生近乎致命的急性冠状动脉综合征的冠状动脉血栓形成的潜在病因。
