Advanced Coronary Atherosclerosis and Fatal Myocardial Infarction in Mild Dyslipidemic, Low Risk Young Man: A Case Report With Literature Reviewed

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Gumpanart Veerakul, MD
Nidcha Ruttapichairuk, MD
Varantiya Ruangmondhop, RN


Acute Myocardial infarction (AMI) at a young age (below 45 years) is rare and difficult to predict. We reported a fatal myocardial infarction from advanced atherosclerosis in a healthy young man who had no other major coronary risk factors except mild hypercholesterolemia. Thus, all available systemic risk scores identified him as a low risk candidate for developing a cardiovascular event. Autopsy revealed advanced atherosclerosis in all three major coronary arteries causing acute and old myocardial infarction. Thick epicardial adipose tissue and myocardial bridging of the mid left anterior descending artery were also noted. He frequently used etoricoxib to treat knee and back pain for consecutive five years. Potential mechanisms of sudden death from atherosclerosis, myo- cardial bridging, epicardial adipose tissue and selective COXIB are discussed in more detail below.


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Veerakul G, Ruttapichairuk N, Ruangmondhop V. Advanced Coronary Atherosclerosis and Fatal Myocardial Infarction in Mild Dyslipidemic, Low Risk Young Man: A Case Report With Literature Reviewed. BKK Med J [Internet]. 2019 Feb. 20 [cited 2023 Dec. 3];15(1):66. Available from:
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