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Cardiology MI can occur in adolescents without cardiac abnormalities
Cardiology MI can occur in adolescents without cardiac abnormalities
MI can occur in adolescents without cardiac abnormalities
Monday, 29 November 1999 19:00 | 
| Specialties - Cardiology |
A case series reported by two cardiologists from Ohio serves as a reminder that myocardial infarction is rare but possible in adolescents with normal coronary arterial anatomy.
A case series reported by two cardiologists from The Heart Center at Akron Children's Hospital, Ohio, in the current issue of Pediatrics serves as a reminder that myocardial infarction is rare but possible in adolescents with normal coronary arterial anatomy.
In the article, Drs. John R. Lane and Giora Ben-Shachar describe nine healthy adolescents (eight boys and one girl), aged 12 to 20 years, who developed severe chest pains and met criteria for myocardial infarction.
Eight of the patients had abnormal electrocardiograms (six with ST elevation and two with nonspecific ST-T abnormalities). All of them had abnormal cardiac enzyme levels and three had echocardiographic abnormalities.
Cardiac dysrhythmias were seen in four patients, three with nonsustained ventricular tachycardia. In five patients, echocardiogram or angiography showed left ventricular focal hypokinesia. None displayed abnormal coronary anatomy.
"Drug abuse, lipid profile, and hypercoagulability studies were negative in all," the authors report.
"What we want to communicate to physicians," Dr. Lane told Reuters Health, "is that myocardial infarction in adolescents is obviously rare but not an impossible diagnosis and shouldn't be dismissed as a possibility when evaluating an adolescent with acute typical chest pain."
MI in adolescents, Dr. Lane noted, is "a different disease than MI in adults; the individuals did not have obvious risk factors, they had angiographically normal coronary arteries, and they tended to recover without long-term consequences."
None of the patients had coronary thrombosis. "We do not see a role for thrombolytic therapy since no thrombosis was involved," Dr. Lane said. On the other hand, "coronary artery vasodilator therapy was helpful, suggesting coronary spasm as the likely etiology of the myocardial ischemia.
In the article, Drs. John R. Lane and Giora Ben-Shachar describe nine healthy adolescents (eight boys and one girl), aged 12 to 20 years, who developed severe chest pains and met criteria for myocardial infarction.
Eight of the patients had abnormal electrocardiograms (six with ST elevation and two with nonspecific ST-T abnormalities). All of them had abnormal cardiac enzyme levels and three had echocardiographic abnormalities.
Cardiac dysrhythmias were seen in four patients, three with nonsustained ventricular tachycardia. In five patients, echocardiogram or angiography showed left ventricular focal hypokinesia. None displayed abnormal coronary anatomy.
"Drug abuse, lipid profile, and hypercoagulability studies were negative in all," the authors report.
"What we want to communicate to physicians," Dr. Lane told Reuters Health, "is that myocardial infarction in adolescents is obviously rare but not an impossible diagnosis and shouldn't be dismissed as a possibility when evaluating an adolescent with acute typical chest pain."
MI in adolescents, Dr. Lane noted, is "a different disease than MI in adults; the individuals did not have obvious risk factors, they had angiographically normal coronary arteries, and they tended to recover without long-term consequences."
None of the patients had coronary thrombosis. "We do not see a role for thrombolytic therapy since no thrombosis was involved," Dr. Lane said. On the other hand, "coronary artery vasodilator therapy was helpful, suggesting coronary spasm as the likely etiology of the myocardial ischemia.
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