Acute ST-Segment Elevation Myocardial Infarction in a 19-Year-Old Due to Uncontrolled Diabetes

ST-segment elevation myocardial infarction (STEMI) is rare in adolescents, especially in the absence of congenital heart disease, hypercoagulable states, autoimmune diseases, or substance use.

We present a case of a 19-year-old man with poorly controlled insulin-dependent type 2 diabetes mellitus and strong familial predisposition for coronary artery disease who presented with STEMI because of complete right coronary artery occlusion and was treated with percutaneous coronary intervention.

STEMI in individuals <20 years of age is exceedingly rare, comprising <1% of acute myocardial infarction cases according to the Framingham Heart Study. The literature reports that such events typically occur in the setting of severe risk factors like congenital anomalies, drug use, hypercoagulable state, or autoimmune disease. Poorly controlled type 2 diabetes mellitus, especially in adolescents, has been increasingly linked to premature atherosclerosis and acute myocardial infarction. The combination of early onset type 2 diabetes mellitus and strong family history of coronary artery disease further underscores this case's rarity and clinical significance.

Early and aggressive management of diabetes is crucial because it significantly contributes to the risk of premature coronary artery disease-particularly in individuals with a strong family history of coronary disease and dyslipidemia.