Clinical Analysis Of 24 Cases With Myocardial Infarction In Young Patients

1. BackgroudCoronary heart disease (CAD) is a common disease of cardiovascular system. It now has been one of the main diseases which hazard human in the world. Recent years, the morbidity and mortality of CHD have being raised year after year with the improvement of standard of living and the change of life style in our country. Results of clinical studies had shown that CHD is the main cause of myocardial infarction (MI) in young patients. The morbidity of MI in the young patients is rising with the increase of CHD morbidity. The young patients with MI have their own characteristics in risk factors, clinical manifestations and findings of coronary angiography (CAG).2. ObjectiveTo investigate the characteristics of MI in young patients by analyzing the risk factors, clinical manifestations and the findings of coronary angiography.3. MethodsThe clinical data (including risk factors of MI, clinical manifestations) and findings of CAG were analyzed intwenty-four cases with MI, aged 45 years, who were admitted to the first affiliated hospital of Zhejiang University from 1997.12 to 2003.9. 4. Results24 cases with MI in young patients accounted for 4.37% of total MI during the same period in our hospital. 21 males, 3 females, with a mean age of 40.6 3.8 (32~45) years. The most frequent risk factors documented in this study in descending order were smoking (66.7 % ), hyperlipidemia (58.2%), positive family history(54.2 %). 12 cases (50%) with MI occurred as the first clinical manifestation without any premonitory symptom. 17 cases (70.8 % ) with MI presented with typical chest pain during the acute attack. The ECG showed a total of 32 infarcted walls in all 24 cases with MI, inferior wall infarction in 16 cases (50%) and anterior wall infarction in 11 cases (34.5 % ) ,the inferior wall were the common locus of MI. In 17 cases underwent CAG, normal coronary artery had been seen in 2 cases (11.8%), fixed stenosis disease in 15 cases with a total of 25 lesion vessels, of which 60 % (9/15) were single-vessel disease. In total of 25 diseased coronary arteries, LAD is the main lesion vessel which account for44%(11/25) .The extent of coronary artery lesions were heavy stenosis and occlusion disease (68%). Of all the patients in the study, CAD is the main cause. No severe complications had been seen in all of the patients and all of the patients were survival during admission. 5. Conclusions(1) The main risk factors of MI in young in descending order were smoking, hyperlipidemia, positive family history.(2) The clinical characteristics of MI in young patients asfollows: (a) The onset of MI in young patients is unexpected with less premonitory symptom, (b) The sign of chest pain is typical during the onset of MI in young patients, (c) The common infarcted locus of MI in young patients is inferior wall, (d) The disease of MI in young patients has less complication, low mortality rate and eusemia. (3) The single-vessel disease is main pathological change in youth patients with MI. Normal coronary artery is frequently seen in young patients with MI.