Acute myocardial infarction at 25 years of age

M. Wayne Falcone, MD, Paul A. Grayburn, MD, and William C. Roberts, MD

A 25-year-old black woman was found to have systemic hypertension when she was 18 years of age. At age 24 she discontinued her antihypertensive medicines for unclear reasons. About 48 hours before hospital admission, she experienced various types of substernal chest pain, which occasionally radiated to her arms. Cardiac catheterization during her first day in the hospital disclosed a large left main coronary artery, which contained a narrowing in its most distal portion, a relatively normal left anterior descending artery, and a totally occluded left circumflex coronary artery.