Coronary Heart Disease in Young Adults

Abstract

Despite the recent decline in mortality from coronary heart disease (CHD), this disease remains the leading killer of US adults of all ages. CHD in young adults is not as well characterized as CHD in older individuals because it occurs less frequently, but this disease can have devastating consequences for young patients and their families. As in older adults, the majority of coronary events in young adults are related to atherosclerosis, and one or more of the traditional CHD risk factors is typically present. Young patients, however, are more likely than older patients to be smokers, male, obese, and to have a positive family history. Risk factor reduction is thus of major importance in managing young CHD patients. Approximately 20% of CHD in young adults, however, is related to non-atherosclerotic factors, such as coronary abnormalities, connective tissue disorders, and autoimmune diseases. Cocaine and other illicit drug use have been increasingly associated with acute myocardial infarction and accelerated atherosclerosis. The differences in etiologies and risk profiles of younger and older CHD patients result in differences in disease progression, prognosis, and treatment. Limited data suggest that prognosis may be better in the young population, although long-term mortality studies have suggested otherwise. Screening for CHD in the young population may help to improve prognosis in young patients by detecting subclinical disease, although more studies are necessary to establish reference limits for this young population. Additional research must also focus on treatment concerns that are specific to young patients.

Unstable Angina Pectoris in a 22-year-old Female Patient

“…It has been classically reported that cigarette smoking and contraceptive use were important risk factors in women [10], as was the case with this patient. Non-arteriosclerosis-related coronary artery diseases, such as idiopathic vasculitis syndrome, Kawasaki disease and Takayasu arteritis, were absent in the present case [11].…”

Clinical and angiographic characteristics of coronary artery disease in young adults: a single centre study

“…Although the aetiology of CAD in young subjects is related to coronary atherosclerosis in 80% of cases, a number of differences regarding both the risk factor profile and clinical and angiographic characteristics exist in comparison to older patients [1,4]. Literature data indicate that young patients with ACS are usually male smokers with abnormal lipid profile, concomitant overweight, and often positive family history for premature CAD.…”

A Rare Cause of Acute Myocardial Infarction: Antiphospholipid Syndrome: Case Report

“…The primary causes other than coronary artery stenosis are coronary artery embolism, thrombosis, anomaly and vessel inflammation or spasm caused by a variety of mechanisms. 1 Although SLE patients are, in most cases, young women who are considered at low risk for coronary atherosclerosis, they have a 2 to 50-fold higher risk of atherosclerotic heart disease, which is a major cause of premature mortality in this disease. 5 The mechanism responsible for the accelerated atherosclerosis process in SLE patients is multifactorial and not fully understood.…”

“…6,7 SLE patients are at a five-fold increased risk for developing coronary heart disease. 1 In addition to these factors, there is an association of SLE with APS. There is a high prevalence of antiphospholipid antibodies in SLE patients (12-34%).…”