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Case Report
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| Is 20s too young to have triple coronary vessel disease? | ||||||
| M. Umair Bakhsh1, Hassan Alkhawam1, Feras Zaiem2, Jaspirt Takher1, Anirudh Pareek1, Mohammed El-hunjul3, Robert Sogomonian1, Neil Vyas1 | ||||||
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1Deaprtment of Medicine, Elmhurst Hospital Center-Icahn School of Medicine at Mount Sinai. Elmhurst, NY, USA.
2Mayo Clinic, Mayo Evidence Based Practice Center. Rochester, MN. 3Department of Medicine, Saint Joseph Hospital, Chicago, IL, USA. | ||||||
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| Bakhsh MU, Alkhawam H, Zaiem F, Takher J, Pareek A, El-hunjul M, Sogomonian R, Vyas N. Is 20s too young to have triple coronary vessel disease? Int J Case Rep Images 2015;6(9):583–586. |
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Abstract
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Introduction:
Coronary artery disease (CAD) remains the leading cause of death in the US in both men and women. This is less frequent in younger population, however, when present CAD can have devastating consequences on the patient and the family.
Case Report: We reported a case of a 28-year-old smoker male with a family history of CAD who presented with dyspnea on exertion. Laboratory examinations were normal for cardiac enzymes and negative for D-Dimer. On admission ECG showed sinus rhythm at 71 bpm, RSR' in V1, S wave in I, Q wave in III, T wave inversion in III. Echocardiogram showed right ventricular systolic function reduced mid portion, preserved at apex and base (McConnell's sign) consistent with acute pulmonary embolism. Patient was started on anticoagulation. Computed tomography angiography (CTA) was also done which was negative for any acute pulmonary embolism, and anticoagulation was discontinued in the light of negative CTA. The patient was discharged from hospital with follow-up in outpatient department. However, the patient came back to emergency department with worsening dyspnea. Lab work was significant for elevated troponin I and ECG on admission showed normal sinus rhythm and S1Q3T3 pattern. Patient had coronary angiography which showed three vessel disease. Conclusion: Smoking is conventionally recognized as the most common risk factor for heart disease. The CAD in young adults has a poor long-term prognosis. Smoking cessation remains a significant challenge in younger population. More awareness and cessation measures are required to address this emerging situation. Given lack of warning signs in these patients, physicians need to be more aggressive in managing risk factors as CAD in younger patient can have adverse outcomes. | |
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Keywords:
Acute coronary syndrome, Coronary artery disease, Vessel disease, Young population
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Author Contributions
M. Umair Bakhsh – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Hassan Alkhawam – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Feras Zaiem – Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published Jaspirt Takher – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Anirudh Pareek – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Mohammed El-Hunjul – Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published Rober Sogomonian – Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published Neil Vyas – Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2015 M. Umair Bakhsh et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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