Acute myocardial infarction in a young elite cyclist: a missed opportunity

Thompson, Christopher Sg; Pass, Marc; Timothy, T.J.; Hung, John; Egred, Mohaned

doi:10.1136/bcr-2018-228560

Cited by 6 publications

(8 citation statements)

References 20 publications

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“…Another case reported a 27-year-old man who had onset of symptoms during a competitive cycling race. 6 This patient was a professional athlete and had no reported risk factors. In that case, angiography was not performed for more than 8 hours because of false reassurance from his young age and fitness status.…”

Section: Discussionmentioning

confidence: 96%

Spontaneous Coronary Artery Dissection in a 19-Year-Old Male Athlete

Bloom,

Eichelberger,

Hackney

et al. 2024

JACC: Case Reports

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Section: Discussionmentioning

confidence: 96%

Spontaneous Coronary Artery Dissection in a 19-Year-Old Male Athlete

Bloom,

Eichelberger,

Hackney

et al. 2024

JACC: Case Reports

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“…Meanwhile, the large amount of free radicals produced in the body will reduce the nitric oxide activity of endothelial cells, resulting in direct damage to cells. Therefore, no reflow phenomenon is related to the aggravation of the inflammatory response[ 12 - 14 ].…”

Section: Discussionmentioning

confidence: 99%

Postoperative adverse cardiac events in acute myocardial infarction with high thrombus load and best time for stent implantation

Zhuo¹,

Zhang²,

Shen³

et al. 2022

WJCC

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BACKGROUND Myocardial infarction is one of the most common types of coronary heart disease. It is mainly caused by the rupture of coronary atherosclerotic plaque, which leads to platelet agglutination and thrombosis. The occlusion of coronary arteries and vessels leads to insufficient myocardial blood supply, subsequently causing cardiac interstitial fibrosis, gradual enlargement of ventricles, and heart failure, which affects the quality of life and safety of patients. AIM To investigate the effects of emergency percutaneous interventional therapy (PCI) and delayed stenting in acute myocardial infarction with high thrombotic load and identify factors related to major adverse cardiovascular events (MACE). METHODS A total of 164 patients with acute myocardial infarction and high thrombotic load who received PCI were included. Of them, 92 patients were treated with delayed stent implantation (delayed group) and 72 patients received emergency PCI (immediate group). Myocardial perfusion after stent implantation was compared between the two groups. Patients were followed up for 12 mo, and the occurrence of MACE was used as the endpoint. Univariate and multivariate models were used to analyze the factors affecting MACE occurrence. RESULTS After stent implantation, 66 (71.74%) patients in the delayed group and 40 (55.56%) patients in the immediate group had thrombolysis in myocardial infarction (TIMI) flow grade 3 ( P < 0.05), while 61 (66.30%) patients in the delayed group and 39 (54.17%) patients in the immediate group reached TIMI myocardial perfusion grade 3 ( P > 0.05). MACE occurred in 29 patients. There were statistically significant differences between the MACE and non-MACE groups in diabetes rate, TIMI grading, stent implantation timing, intraoperative use of tirofiban, and the levels of white blood cells (WBC), neutrophils, red blood cell distribution width (RDW), and uric acid, and high-sensitivity C-reactive protein (hs-CRP) at admission ( P < 0.05). Logistic regression analysis showed that TIMI grade 3 and intraoperative use of tirofiban effectively reduced the risk of MACE ( P < 0.05), while immediate stent implantation, increased WBC, hs-CRP and RDW on admission increased the risk of MACE ( P < 0.05). CONCLUSION Delayed stent implantation outweighs emergency PCI in improving postoperative myocardial perfusion in acute myocardial infarction with high thrombotic load, and effectively reduces MACE in these patients.

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“…Several cases of MI associated with coronary artery dissection in young athletes have been described. It is a non-traumatic and non-iatrogenic spontaneous separation of the coronary artery wall [10,14,15]. Coronary artery dissection is more commonly observed in women [16].…”

Section: Spontaneous Coronary Artery Dissection (Scad)mentioning

confidence: 99%

“…Coronary artery dissection may not be visible on coronary angiography [14]. The findings on an angiogram can resemble those seen in acute atherosclerotic plaque disease, coronary artery spasms, coronary thromboembolism, or even normal coronary arteries; however, advanced imaging techniques such as intravascular ultrasound and optical coherence tomography provide higher resolution, enabling more precise identification of the dissection flap and the accompanying intramural hematoma [10]. These techniques are recommended in the diagnosis of spontaneous coronary artery dissection [10].…”

Section: Spontaneous Coronary Artery Dissection (Scad)mentioning

confidence: 99%

“…In young athletes under 35-40 years old, the occurrence of MI type I, which is typically associated with atherosclerosis resulting from risk factors such as obesity, diabetes, smoking, or dyslipidemia, is only one of the mechanisms [9,10]. Many MIs are of the type II mechanism caused by oxygen supply-demand mismatch from abnormalities of the coronary arteries, spontaneous coronary artery dissection, coronary artery spasm, hypercoagulability, or consequences of anabolic steroids use.…”

Section: Introductionmentioning

confidence: 99%

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Myocardial Infarction in Young Athletes

Dotka,

Małek

2023

Diagnostics

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Myocardial infarction (MI) in young athletes is very rare but can have serious consequences, including sudden cardiac death (SCD), an increased proarrhythmic burden in future life, and/or heart failure. We present two cases of young athletes with MI. They did not have previous symptoms, traditional risk factors, or a family history of MI. One case involves a 37-year-old male amateur athlete who experienced two MI following intense physical exertion, likely due to the erosion of an insignificant atherosclerotic plaque caused by a sudden increase in blood pressure during exercise. The second case describes a 36-year-old male semi-professional runner who collapsed at the finish line of a half-marathon and was diagnosed with hypertrophic cardiomyopathy. The heart’s oxygen demand–supply mismatch during intensive exercise led to MI. Following the case presentation, we discuss the most common causes of MI in young athletes and their mechanisms, including spontaneous coronary artery dissection, chest trauma, abnormalities of the coronary arteries, coronary artery spasm, plaque erosion, hypercoagulability, left ventricular hypertrophy, and anabolic steroids use.

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Acute myocardial infarction in a young elite cyclist: a missed opportunity

Cited by 6 publications

References 20 publications

Spontaneous Coronary Artery Dissection in a 19-Year-Old Male Athlete

Spontaneous Coronary Artery Dissection in a 19-Year-Old Male Athlete

Postoperative adverse cardiac events in acute myocardial infarction with high thrombus load and best time for stent implantation

Myocardial Infarction in Young Athletes

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