Objectives: To determine the pattern of coronary artery diseases (CAD) in patients under 40 years of age with acute coronary syndrome (ACS) presenting at Hyderabad Satellite Center of National Institute of Cardiovascular Disease (NICVD), Pakistan. Methodology: This cross-sectional study was conducted at cardiology department of the NICVD, Hyderabad Satellite Center. Both male and female patients, between 18 to 40 years of age, diagnosed with acute coronary syndrome (ACS), and undergone coronary angiography were included in this study. Angiographic patterns in terms of extent of the disease (number of diseased vessels and localization of lesion) were assessed. Results: Total of 220 young patients included. Patients were predominantly male (91.8%) with the mean age of 35.3 ± 5 years. Smoking was observed 30.5% followed by hypertension (24.5%) and positive family history of CAD (19.1%). A majority of the patients (79.1%) were diagnosed as with ST-elevation myocardial infarction (STEMI) with anterior wall myocardial infarction (MI) as the most common (57.3%) type of MI. Most of the patients (70%) had single vessel diseases (SVD) with left anterior descending artery (LAD) as the most commonly diseases vessel (53.6%). Nine (4.1%) patients had significant left main disease and 6.4% had non-obstructive CAD. Conclusion: The common clinical presentation of ACS in younger patients is STEMI. Smoking is the commonest risk factor followed by hypertension and family history of CAD. More than 2/3rd of the young patients are expected to have single vessel diseases with LAD as the most commonly diseased vessel.

Objective: To determine the frequency of arrhythmias in patients with acute coronary syndrome (ACS) in a tertiary care hospital, Karachi, Pakistan. Methodology: This cross-sectional study was conducted at cardiology department of a tertiary care hospital of Karachi, Pakistan. A total of 189 consecutive patients of either gender presented with ACS during six months of study period were included. Continuous cardiac monitoring (telemetry) was done to record any arrhythmia within 24 hours of onset of symptoms. Results: 189 patients with ACS were included, 152 patients (80.4%) were males with the mean age of 48.23 ± 6.717 years. This included 95 patients (50.3%) with unstable angina, 36 patients (19.1%) with ST elevation myocardial infarction (STEMI), and 58 patients (30.7%) with Non-STEMI. Arrhythmias were seen in 39 patients (20.6%), most commonly observed type of arrhythmia was premature ventricular contractions (12), atrial fibrillation (nine), ventricular tachycardia (seven), and ventricular fibrillation (five). Conclusion: Arrhythmias were reported in 39 patients from the total, accounting for 20.63% of the entire population. The incidence of cardiac arrhythmia was more in the age group 40-60 years and male population.