Acute Myocardial Infarction in a 26-Year-Old Man with Normal ST-Segment

Acute myocardial infarction (AMI) is rare in young adults. The management of these patients is considered as a clinical challenge. We report the case of a 26-year-old man who was presented to the Emergency Room of Affiliated Hospital of Guilin Medical University with an acute onset of chest pain. Initially electrocardiogram (ECG) with no evidence of ST-segment abnormalities but QT prolongation a signal of sudden cardiac death, 20 minutes later, it revealed ST-segment elevation myocardial infarction (STEMI). Coronary angiography (CAG) demonstrated left main coronary artery occlusion. AMI was diagnosed based on clinical symptom, elevated cardiac biomarkers, electrocardiographic dynamic monitoring and CAG. The awareness of chest pain as possible underlying AMI symptom—especially in young patients presenting with QT prolongation—is crucial for clinical treatment, as a missed diagnosis can worsen the patient’s further prognosis. In addition, reperfusion arrhythmia is a challenge to short-term outcomes of young patients with AMI, so it is necessary to make preoperative risk stratification.