Objective: We sought to study the clinical profile, presentations and in hospital outcome of acute coronary syndromes (ACS) among young patients 18-45 years of age presenting to King Faisal Cardiac Center in the eastern province of Saudi Arabia. Methods: Retrospective Single center study of all patients 45 years or younger who presented to King Faisal cardiac center with acute coronary syndrome from the period between august 2014 till December 2017. All data were obtained from health informatics system. Descriptive data of risk factors, clinical presentation, angiographic results and in hospital outcome were reported. Results: During the study period 1242 patients were admitted with ACS among them 56 patients (4.5%) were forty five or younger. Majority were males 52 patients 92 %. Smoking and dyslipidaemia were seen among 78% and 28% respectively. Mean age was 38 years (SD±5.3). STEMI was the presenting syndrome among thirty two patients 57% and NSTEMI among 30 % of the patients. Normal coronaries were seen in 11 patients 23%. The left anterior descending artery was the infarct related artery in 19 patients 47%. Many patients had only single vessel disease. Percutaneous intervention was performed in 27 patients 67%. No adverse in hospital and 30 days events were encountered. Conclusion: Smoking is a prevailing risk factor among young patients presenting with ACS. Majority have a favourable short term outcomes.
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