Acute Myocardial Infarction in a Young Man with Hyperhomocysteinemia and Pulmonary Tuberculosis

Abstract

Acute myocardial infarction, hyperhomocysteinemia and pulmonary tuberculosis (PTB) are rare in individuals under the age of 30 years. We herein report the case of a 27-year-old man who presented with intermittent chest pain, elevated homosysteine level, and PTB. The patient was treated successfully with a combination of medications and percutaneous coronary intervention. This uncommon case highlights that homocysteine, folate and B vitamins levels should be regularly evaluated, and that chest X-rays or thoracic computed tomography should be ordered routinely to exclude PTB in patients under the age of 30 years who present acute myocardial infarction and lack the traditional risk factors.

Clinical evaluation of myocardial involvement in acute myopericarditis in young adults

“…Among these may be drug abuse, congenital coronary abnormalities, coronary spasm, trauma, systemic vasculitis, and hematologic disease [1]. Acute myopericarditis, one of the myocardial involvements in young adults, manifests itself with chest pain, increased cardiac biomarkers, and ST-segment elevation, ST-T changes in electrocardiography [2–4].…”

Toxicoproteomic Profiling of hPXR Transgenic Mice Treated with Rifampicin and Isoniazid

“…Antitubercular therapy is associated with homocysteinemia [ 12 , 60 , 61 ]. Proteins involved in homocysteine metabolism were affected by antitubercular therapy in our analysis ( Supplementary Table S10 ).…”

“…Patients with tuberculosis are at an increased risk of deep vein thrombosis (DVT), pulmonary embolism (PE), and ischemic stroke [ 76 , 77 , 78 ], and antitubercular therapy may increase these risks, in addition to increased myocardial infarction risk [ 11 , 12 , 13 , 60 ]. Additionally, antitubercular therapy may cause homocysteinemia, which increases coagulability [ 12 , 60 , 61 ]. We found decreased cystathionine β-synthase in all treatment groups in an hPXR -independent manner.…”