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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina


Ž. Raić, A. Arslanagić and F. Švraka
Clinic for Heart Diseases and Rheumatism, Clinical Center University of Sarajevo, Bosnia and Herzegovina

Acute myocardial infarction in patients younger than 30 is rare. Patient M.S. age 26, traffic technician was presented with chest pain on day of hospitalization. Risk factor: 10 years of smoking, 30 cigarettes per day (alcoholism and other factors were negative). On examination: conscious, normal lung sound, blood pressure 120/80 mmHg, heart rate 76/min. ECG examination: elevated ST in II, III, aVF leads, high R in V1-3. Biochemical findings were positive: CPK 4.96. Ultrasound examination of the heart: mild to moderate hypokinesis of the inferoposterior wall, other kinetics normal, EF 56%. Patient was treated with heparin (he was late for fibrinolytic treatment). ECG evolution: on discharge: sinus rhythm, rate 55/min, q in II, III, aVF leads with negative T wave in same leads, high R in V1-3. Patient underwent coronarography: hypokinesis of posterobasal wall, normal left ventricle. EF 64%. Coronary status normal. Regarding ECG changes and normal coronary status on coronarograpy examination possible cause of AMI was spasm.

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