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Acute Myocardial Infarction in a Young Lady due to Vitamin B12 Deficiency Induced Hyperhomocysteinemia

Warkaa Al Shamkani1, Nagham Saeed Jafar1, Sunil Roy Narayanan1

  • 1Department of Cardiology, Belhoul Speciality Hospital, Dubai, UAE.

Heart Views : the Official Journal of the Gulf Heart Association
|April 4, 2015
PubMed

Insights

Elevated homocysteine levels, often due to nutritional deficiencies, can cause heart attacks in young adults. Early evaluation for hyperhomocysteinemia is crucial, especially in patients without traditional risk factors.

Area of Science:

  • Cardiology
  • Nutritional Science
  • Internal Medicine

Background:

  • Hyperhomocysteinemia is an established risk factor for coronary artery disease (CAD).
  • Younger patients with myocardial infarction (MI) often lack conventional cardiovascular risk factors.
  • Nutritional deficiencies can contribute to elevated homocysteine levels.

Observation:

  • A 32-year-old obese female presented with acute anterior wall MI.
  • Echocardiography revealed anterior wall hypokinesia and moderate left ventricular dysfunction.
  • Coronary angiography demonstrated significant stenosis in the left anterior descending (LAD) artery.

Findings:

  • The patient had low vitamin B12, folate, and serum iron levels.
  • Elevated serum homocysteine levels were detected.
  • Following supplementation with folic acid and vitamin B12, homocysteine levels normalized and percutaneous coronary intervention (PCI) to the LAD was successful.

Implications:

  • This case highlights nutritional deficiencies as a potential cause of MI in young individuals.
  • Hyperhomocysteinemia should be considered in the etiological evaluation of MI in young patients, particularly those without traditional risk factors.
  • Screening for vitamin deficiencies and homocysteine levels may aid in preventing cardiovascular events.

Keywords:
Myocardial infarctionhyperhomocyteinemiarisk factorsvitamin B12 deficiency

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