[SUDDEN CARDIAC DEATH IN A YOUNG ADULT WITH DIFFUSE CORONARY ARTERY DISEASE]
Diab Ghanim1,2, Erez Kachel1,3,4, Jacob Lavie1,3,4
1Cardiovascular Institute, Baruch Padeh Medical Center, Poriya, Lower Galilee.
Insights
A high school student experienced sudden cardiac death due to diffuse coronary artery disease. Prompt treatment with stenting and extracorporeal membrane oxygenation (ECMO) led to a full recovery.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Sudden cardiac death (SCD) in young individuals is rare.
- Diffuse obstructive coronary artery disease is an uncommon cause of SCD in adolescents.
- This case highlights an unusual presentation without typical risk factors.
Observation:
- A previously healthy high-school student presented with out-of-hospital SCD, unconscious and intubated.
- Initial investigations revealed no typical risk factors for premature CAD, including family history, substance abuse, or hyperlipidemia.
- Emergent coronary angiography showed diffuse obstructive CAD, necessitating stent placement.
Findings:
- The patient experienced hemodynamic instability, requiring extracorporeal membrane oxygenation (ECMO) support.
- Extensive work-up, including cardiac MRI, failed to identify the etiology of the premature CAD.
- An empirical trial of steroids was administered.
Implications:
- This case highlights the importance of considering aggressive cardiovascular evaluation in young patients with unexplained SCD.
- Despite the rarity, diffuse CAD can manifest severely in adolescents without predisposing conditions.
- Complete recovery is possible with timely and intensive multidisciplinary care, including mechanical circulatory support.
Introduction:
We present a very unusual case in which a high-school student was admitted to our cardiac center unconscious and intubated after suffering from out of hospital SCD. There was no history of fever, substance abuse, family history of sudden cardiac death and/or coronary artery disease, arthralgia, hypercoagulable state or familial hyperlipidemia. An emergent coronary angiogram revealed diffuse obstructive coronary artery disease which was treated with several stents. The following days of his admission were characterized by hemodynamic instability, necessitating temporary support via extracorporeal membrane oxygenation (ECMO), from which he was weaned off at a later stage. A full work-up regarding the etiology of the premature coronary artery disease was negative including cardiac magnetic resonance imaging, yet an empirical steroids course trial was given. Eventually, the patient regained full recovery, both cardiac and neurological, and returned to his usual daily activities.
Background:
Diffuse coronary artery disease at a young age, manifesting itself as sudden cardiac death (SCD) is a rare event.
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