Myocardial Infarction in a Young Man due to a Hypoplastic Coronary Artery

Area of Science:

• Cardiology
• Medical Imaging
• Genetics

Background:

• Hypoplastic coronary artery disease (HCAD) is a rare congenital condition.
• HCAD can lead to myocardial infarction (MI) and sudden cardiac death, even in young individuals.
• Diagnosis often requires advanced imaging techniques.

Purpose of the Study:

• To report a case of HCAD presenting as MI in a young adult.
• To highlight the diagnostic challenges and imaging findings associated with HCAD.
• To emphasize the importance of considering HCAD in young patients with MI.

Main Methods:

• Case report of a young male patient with chest pain and MI.
• Electrocardiography (ECG) and echocardiography for initial assessment.
• Coronary angiography to visualize coronary arteries.
• Myocardial perfusion scintigraphy (99mTc-tetrofosmin).
• Cardiac CT and cardiac MRI for detailed cardiac structure and function evaluation.

Main Results:

• The patient presented with symptoms consistent with MI.
• ECG showed anterior ST-elevation with Q waves; echocardiography revealed LV dysfunction.
• Coronary angiography confirmed hypoplasia of the left anterior descending (LAD) artery.
• Perfusion scintigraphy demonstrated a large, fixed perfusion defect.
• Cardiac CT and MRI confirmed chronic MI with apical wall abnormalities.

Conclusions:

• HCAD, though rare, should be considered in the differential diagnosis of MI in young individuals.
• Multimodality imaging plays a critical role in diagnosing HCAD and associated cardiac damage.
• Timely diagnosis and management of HCAD can potentially prevent adverse cardiovascular events like sudden cardiac death.