Circadian pattern of symptoms onset in patients ≤35years presenting with ST-segment elevation acute myocardial infarction

Symptomology, Outcomes and Risk Factors of Acute Coronary Syndrome Presentations without Cardiac Chest Pain: A Scoping Review

“…With regards to time frames, three articles specified typical chest pain lasted >20 minutes, one study stipulated chest pain of >30 minutes, while the majority of papers did not specify a time duration as typical. [ 25 , 29 , 34 , 35 ] It was unclear what occurred with participants who may have experienced pain but of a duration less than those specified – whether they were excluded, considered atypical or other. El-Menyar et al did not provide a time frame, but defined atypical as not severe, not prolonged or not typical in nature and placed those presenting with dyspnoea as one of three separate groups (typical symptoms of myocardial ischaemia; atypical chest pain; and dyspnoea) during their analyses, excluding other anginal equivalents (e.g.…”

Optical coherence tomography guided thrombectomy through a “home-made” aspiration catheter in a young patient with myocardial infarction. To stent or not to stent?

“…In addition, STEMI is an uncommon entity in young adults and its incidence depends on the cut-off age used [15]. Most studies have used an age cut-off of 40-45 years to define young patients with STEMI [3].…”

“…Most studies have used an age cut-off of 40-45 years to define young patients with STEMI [3]. It has been reported that < 1% of patients with STEMI are ≤ 35 years [15]. Young STEMI patients differ from older patients in the risk factor profile and in the extent of atheromatic plaque coronary burden.…”

“…Young STEMI patients differ from older patients in the risk factor profile and in the extent of atheromatic plaque coronary burden. In particular, young coronary patients are characterized by a higher proportion of heavy smoking, a lower proportion of hypertension and diabetes mellitus and a relatively high proportion (15-20%) of angiographically "normal" coronary arteries [15]. Apart from the classical mechanism of plaque rupture, MI in young individuals can be attributed to plaque erosion, coronary microvascular dysfunction, SCAD, myocarditis, coronary embolism, hypercoagulable state and coronary spasm related or not to drug use (e.g.…”

A 24-year-old male with acute coronary syndrome due to the circumflex coronary artery thrombosis. Diagnostic challenge in everyday practice

“…In morning hours, the occurrence of ACS was typical for young patients. Rallidis LS et al showed a circadian pattern with a morning peak of ST-segment elevation MI in patient ≤ 35 years of age [4]. This may be associated with many factors including higher sympathetic activity, higher platelet aggregation and lower plasma fibrinolytic activity in morning hours.…”