Acute chest pain in young male

MBBS
, ,
1

1.Presentation

  • 26-year-old male with sudden, severe chest pain radiating to the left arm
  • Associated symptoms: sweating, shortness of breath
  1. Risk Factors
  • Chronic smoker
  • Positive family history of coronary artery disease
  1. Initial Assessment
  • Vitals stable
  • ECG: ST elevation in anterior leads
  • Cardiac enzymes: ordered to confirm myocardial infarction
  1. Differential Diagnosis
  • Acute coronary syndrome (ACS)
  • Aortic dissection
  • Pericarditis
  • Gastroesophageal reflux
  • Panic attack
  1. Emergency Management (MONA Protocol)
  • Morphine
  • Oxygen
  • Nitrates
  • Aspirin
  1. Further Workup
  • Echocardiography
  • Troponin levels
  • Risk stratification and cardiology consult

Learning Point

  • Always consider cardiac causes, even in young patients with risk factors—age alone doesn’t rule out myocardial infarction.
3 Likes
2

Cardiac ischemia should be considered in young people too. :white_check_mark::white_check_mark:

2 Likes
3

It can be cardiac ischemia.
It’s rule out by ST elevation and the patient is a chronic smoker and has a family history of CAD.

1 Like
4

Apart from the given ddx :-

It can be

  1. Myocarditis that can mimic myocardial infarction

  2. Variant angina with transient ST elevation

  3. Cardiomyopathy with exertional chest pain

  4. Pulmonary causes like pneumothorax and pleuritis

1 Like
5

It can be angina, and cardiomyopathy apart from givr ddx

6

It looks like a case of Cardiac Ischemia.