ABSTRACT
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. Her father had died at age 51 of acute myocardial infarction. The patient was subsequently discharged, but about 1 month later, chest pain reccurred and she was rehospitalized. Additionally, a new narrowing was found in the left anterior descending coronary artery, and intravascular ultrasonic imaging showed it to be a 70% cross-sectional area narrowing. The frequency of acute myocardial infarction in persons 22-45 years of age is relatively uncommon, particular in women. Nevertheless, acute myocardial infarction in the 20s is extremely rare. A number of studies have demonstrated that the number of atherosclerotic risk factors in young patients with acute myocardial infarction is considerably larger than in older patients with acute myocardial infarction.
