Not too young for a Heart Attack!

Acute myocardial infarction in the 20s is extremely rare. A number of studies have demonstrated that the number of atherosclerotic risk factors in young patients with acute myocardial infarction (MI) is considerably larger than in older patients with acute MI. Recently, SRV Group of Hospitals witnessed and successfully treated two such rare instances of MI in very young adults.

Case 1: MI in a 24-year-old male due to high homocysteine levels

Recently, the Department of Cardiology at SRV Mamata Hospital, Dombivli successfully treated a 24-year-old male, who was presented in emergency with the complain of chest pain while he was relaxing at home. Patient had chest pain for about 10-15 minutes, so he was taken to the nearby doctor. ECG was performed, which revealed a minor heart attack has passed few hour before. Without wasting time, the patient approached SRV Mamata for further treatment. On arrival at the hospital, he was diagnosed with 95% blockage in major coronary artery (LAD).

The patient did not had any common risk factors for this event like heavy smoking, deranged lipid profile, diabetes, stressful lifestyle nor any family history of heart disease. Neither he was obese nor having sedentary lifestyle.

Patient underwent series of tests that revealed his homocysteine levels were slightly high. Raised homocysteine levels are known to cause accelerated atherosclerosis, which can lead to heart attacks and other vascular disease.

Most people who have a high homocysteine level don’t get enough folate, vitamin B6, or vitamin B12 in their diet. Replacing these vitamins often helps in returning the homocysteine levels to normal. However, it is now widely accepted that food sources alone cannot consistently supply the levels of nutrients necessary to sustain optimal homocysteine metabolism.

Homocysteine is normally changed into other amino acids for use by the body. High levels of it are linked to early development of heart disease.

Case 2: MI in a 22-year-old male due to high HbA1c

A 22-year-old male was brought to SRV Hospital, Goregaon who got an acute MI. The boy was admitted under Dr Harish Bajaj, Interventional Cardiologist at SRV Hospital. On arrival, his blood glucose level was 273 mmHg. There were not evident risk factors or reported CVD incidences. However, on history taking it was found that the boy’s father was a diabetic.

It is suspected that the patient never realized that he was also diabetic from an early age as there were no signs and symptoms. However, due to prolonged and uncontrolled blood glucose levels, he got MI.

Diabetes, by driving inflammation and slowing blood flow, dramatically accelerates atherosclerosis. Atherosclerotic plaque deposition in heart vessels may start at very early age and it can abruptly rupture causing blockage of vessel which could result in major heart attack.

Number of MI cases below 35 years of age has increased dramatically in the recent past; it is advisable not to ignore even the minutest signs of chest pain or discomfort and get an ECG done.