Sudden death associated with silent myocardial infarction in a 35-year-old man: a case report

Abstract

BackgroundSilent myocardial infarction relates to the absence of symptoms usually associated with myocardial ischemia. It has been estimated that silent myocardial infarction can occur in 2–4 % of young adult asymptomatic men. A majority of patients without an initially apparent cause of sudden death have been found at autopsy to have had significant coronary heart disease, including old, undetected myocardial infarction. Cases of sudden death in young men with unrecognized silent myocardial ischemia seem to be underreported, however.Case presentationA 35-year-old Norwegian man without a previous medical history died suddenly without preceding symptoms of coronary ischemia. Apart from elevated lactate, his laboratory test results were within normal limits. An autopsy revealed advanced coronary artery thrombosis of the left anterior descending branch with an extensive, partly organized myocardial infarction. The results of toxicological examinations of peripheral blood were negative for usual narcotics and alcohol.ConclusionsSudden, unexpected death due to myocardial infarction can occur even at a young age in patients without known coronary heart disease.

Case report of an acute myocardial infarction complicated by coronary spasm in a patient with chronic systemic lupus erythematosus

“…Angina pectoris is the most common presentation of a patient with AMI [ 4 ] and the chest pain is typically described as a sensation of dullness, tightness or squeezing, and it most often radiates to the left arm, the lower jaw, the neck, the right arm, back and epigastrium. It can also present with other symptoms or even be asymptomatic in some cases [ 5 ]. On an ECG, ST-elevation in leads II, III, and aVf (inferior leads) usually reflect an occlusion of the right coronary artery (RCA) or in less intense an occlusion of the left circumflex (LCX).…”

Autopsy Report of Sudden Death with Findings of Polyembolokailomania – A Rare Psychiatric Disorder

“…(17) In this setting, autopsy represents the first, and only, opportunity to establish and register an accurate cause of death. (8)…”

“…(7) At autopsy, patients initially without any apparent cause of sudden death have been found to have had significant coronary heart disease, including old, undetected myocardial infarction. (8)…”

Nebyliojo Miokardo Infarkto Apibrėžimas, Rizikos Veiksniai Ir Ryšys Su Staigia Mirtimi

“…Literatūroje pateikiama netipiško MI skausmo definicija nėra pakankamai tiksli. Kai kurie autoriai necharakteringiems MI požymiams priskiria šiuos simptomus: 1) mažesnio intensyvumo tipinius krūtinės anginos skausmus − diskomfortą krūtinės, rankos, apatinio žandikaulio srityse [8]; 2) klinikinius simptomus, pasireiškiančius neįprastinėse MI vietose − skausmą nugaros ar epigastriumo srityje, panašų į nevirškinimo jausmą arba apibūdinamą kaip duriantį ar deginantį [9]; kaip nespecifiški simptomai įvardinami ir su krūtinės skausmu nesusiję požymiai, tokie kaip tachikardija, palpitacijos, diaforezė, ryškus nuovargis ar dusulys [5][6][7]10]. Kaip jau aptarta, nors didžioji dalis NMI atvejų nėra mirtini, simptomų išraiškingumas ne visada koreliuoja su pažeidimo plotu, todėl skubiosios pagalbos skyriuose ypač aukštos rizikos pacientams, atvykusiems su netipiniais simptomais, kliniškai visada turėtų būti įtariama MI diagnozė.…”