[Acute myocardial infarct in patients under 30 years old]

Between 1980 and 1985 nine patients under the age of 30 were admitted to our hospital with acute myocardial infarction. They represented 4% of all patients with acute myocardial infarction. Coronary angiography was performed in 8 patients and in a high proportion (5 patients) no stenotic lesion was found. In these patients, vasospasm seems to be the most likely pathogenesis. In one patient no angiography was performed; he had stopped anticoagulation therapy after aortic valve replacement and therefore coronary embolism was the obvious reason for the infarct. After a median of 5 years (2-7) no patient had died or had suffered a new coronary event. The 5 patients with angiographically normal coronary arteries had ceased taking medication and were all back to work full time. Psychological evaluation showed impaired ability to express aggression in all 9 patients.