VolumeVol. 56 • Number No. 4 • October - December 2018 Back

Original Article

Acute Myocardial Infarction in Very Young Filipino Adults ​​​​​​​

Authors: Emily Mae L. Yap, Ana Beatriz R. Medrano

DOI: 10.65564/pjim.351680613d

Date of Publication: December 2018

Abstract

Introduction: Acute myocardial infarction (AMI) is rare in “very young” patients and studies among Filipinos are scarce. The objective of this study is to determine the prevalence, clinical, echocardiographic and angiographic features, and outcome of this population.

Methods: A retrospective study of patients aged 19 to 30 years old who were diagnosed with AMI at the Philippine Heart Center from 2012 to 2016 was done.

Results: The prevalence of AMI in very young Filipino adults at our institution was 0.93% (11/1182). The mean age was 26.5±3.4 years with a male predominance (82%). Chest pain was the most common symptom (91%). More than half of the patients did not have heredofamilial diseases. Eight patients were smokers (72%). There was one case of illegal drug use (methamphetamine) (9%). There were only two cases of non-ST elevation myocardial infarction (NSTEMI) (18%). ST elevation myocardial infarction (STEMI) of the anterior wall was seen in four cases (36%), inferior wall in three cases (27%) and anterolateral wall in two cases (18%). Six patients (45%) had left anterior descending artery (LAD) involvement. Two patients (18%) had right coronary artery (RCA) involvement. Two patients (18%) had both LAD and RCA involvement. The youngest patient, a 19-year-old female with Takayasu arteritis, had three-vessel involvement. Five patients (45%) underwent percutaneous coronary involvement (PCI) of the LAD while two had PCI of the RCA (18%). All patients were discharged improved.

Discussion: Acute myocardial infarction (AMI) in the young has not been extensively studied among Asians. Chest pain is the most common clinical presentation with STEMI being more frequent than NSTEMI in this age group. Male gender and smoking were the most common risk factors.

Conclusion: Early recognition and prompt management of AMI, particularly revascularization (if indicated), are of paramount importance to optimize outcomes.

Keywords: acute myocardial infarction, young, Filipinos, smokers

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