Left Main Stem Stenosis in Young Female without Significant Cardiovascular Risk Factor

Author : V Kurniawati, S.Rohman
Upload Date : 19-04-2018

Background: Left Main coronary artery disease causes a high risk of death and adverse outcome. The Framingham Heart Study reported 10-year incidence of  `young` MI (defined as <55 years of age) as high as 7.4/1000 women. The higher prevalence of risk factor in `young` MI are smoking, family history of premature coronary heart disease (CHD) and male gender. We present interesting case of a young female without significant cardiovascular risk factor presenting a Left Main stenosis.

Objective: To demonstrate acute coronary syndrome in young female without significant cardiovascular risk factor

Case presentation: A 40-year-old woman with no significant cardiovascular risk factor, was admitted with  severe chest pain onset one hour before admission accompanied with sweating and shortness of breath. There was history of  intermittent chest pain since ten days before admission.  There is no  family history of familial hypercholesterolemia and premature CHD. She is a worker at cigarette factory.

On admission, hemodynamic was stable KILLIP I. The electrocardiogram revealed ST segment elevation at aVR and widespread ST segment depression.  After initial evaluation, coronary angiography (CAG) was immediately performed. The CAG revealed stenosis 95% in osteal proximal LM.  The lesion was stented with 3.5 x 20 mm Drug Eluting Stent. The patients has improved symptomatically and discharged in hemodynamically stable condition

Conclusion: Acute coronary syndrome should be considered in young female without significant cardiovascular risk factor presenting with typical chest pain

KEYWORDS : LM stenosis, young female

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