What's the Youngest CAD/MI Pt. You've Had?

  1. Lately I've been seeing more and more younger CAD/MI patients coming in for CP, caths, and CABGs. Mostly 30s-40s. What's the youngest you all are seeing?
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  2. 16 Comments

  3. by   papawjohn
    Hey Lovern

    We both are up too late. Here in Florida we have all sorts of storys about the aging of our population. (One true story...I went to a St Paddy's day celebration at an "Irish" theme bar on the barrier island. They'd set up a special 'St Patty's Day tent' in the parking lot. And all of the bouncers were grey-headed!!) We joke--St Pete is 'God's waiting room'. If you leave your glass of water too long, some one will put their teeth in it.'

    Around here, we sometimes see folks in early 30s with documented + troponines and Cardiac Caths. Backgrounds usually include Diabetes.

    Don't understand the pathophysiology but IDDM really really tips folks toward CAD---esp if you throw in cigarettes since age 14.

    Papaw John
    Cig Free Since '81
  4. by   suzanne4
    Through the years, I have had several patients with acute MIs, and well documented with such, at 27 years of age.

    I have also seen a couple of kids in their teens with MIs, but this was more related to congenital heart disease. But they were still MIs.

    So, if you are in the ER working, and a "relatively" young person comes in with chest pian, do not rule them out strictly on age.
  5. by   LilgirlRN
    Yeah, you just never know. You never know who's been doing tons of meth or smoking crack, snorting coke etc. Those are the young MI's that I have seen. Yesterday we had a 17 year old that woke up in the niddle of the night with chest pain. His mom insisted that he come in and be evaluated even though the pain was gone for the most part. he rated it 2/10. EKG showed WPW... wolfe-parkinson-white syndrome. His pain had lessened because his HR wasn't up, at least that's the hypothesis. Most doc's wouldnt have done and EKG on someone that young, thank goodness this one did.
  6. by   tvccrn
    She was 8 years old and it wasn't congenital, but there was a very strong family history of early arrests.
  7. by   zambezi
    Youngest I have seen is 18...enzymes etc were all elevated (thankfully fairly mildly)...took the kid to cath lab- clean coronaries...turns out he had an allergic reaction to something which caused sob/vasospasm of the coronary arteries (enough for continued cp)...

    The yougest recent surgery I have seen for non congenital reason was 31- and he had to come back a couple of months later for a stent...healthy guy too (by that I mean he didn't smoke, he worked out and looked fit, normal body weight- he did have some other medical issues that may have contributed though).

    FYI-there was a thread on this exact subject a while ago too...
  8. by   SEOBowhntr
    I think I may take the cake here with a 24yo M with moderate to severe CAD, requiring CABG I cared for about 6 yrs. ago, and a 28yo F I took care of about 3 yrs. ago who'd had a 4 vessels CABG. Both of her parents died before 40. I've seen many MI's in young 18-30yo's that were Coke related, but those had nothing to do with CAD, they were self-inflicted.
  9. by   suzanne4
    With cocaine, the worst that I have seen was a dissecting thoracic aneurysm, and it wasn't a pretty picture............especially since it was in a smaller facility that did not have a heart team.
  10. by   HillNPStudent
    Quote from SEOBowhntr
    I think I may take the cake here with a 24yo M with moderate to severe CAD, requiring CABG I cared for about 6 yrs. ago, and a 28yo F I took care of about 3 yrs. ago who'd had a 4 vessels CABG. Both of her parents died before 40. I've seen many MI's in young 18-30yo's that were Coke related, but those had nothing to do with CAD, they were self-inflicted.
    Did this guy have familial hypercholestrolemia or some other sort of lifestyle factor/explainable cause for CAD so early? I've seen several early MIs but mostly due not only to a strong family history but poor lifestyle factors-overweight, DM, smoker...etc....
  11. by   SEOBowhntr
    Quote from LOVERN
    Did this guy have familial hypercholestrolemia or some other sort of lifestyle factor/explainable cause for CAD so early? I've seen several early MIs but mostly due not only to a strong family history but poor lifestyle factors-overweight, DM, smoker...etc....
    Lovern,
    He actually had strong family history and was living a healthy lifestyle, non-smoker, active duty military, regular workouts, etc, and when he had the chest pain, he had to argue with the ER doc, telling him that this pain WAS his heart, and he knew he needed and EKG. He WAS right, unfortunately. He also was super nice, super scared young man, whom I felt very bad for. He left the hospital on post-op day 4, looking like a million bucks, unfortunately, I'd suspect he probably will never see 40!!!
  12. by   psalm
    ...in the early 1970's when I was an Army WAC I went on leave for a week. When I returned I learned an acquaintence had a heart attack and died at age 21. His father reportedly died at age 40. Don't know if drugs were a factor.
  13. by   Dinith88
    I have the winner....

    An 11 year old female w/advanced coronary disease, had been a smoker for 12 years, diabetic for 12 1/2 years...strong family history (both parents died in middle school from MI's.)


  14. by   lalaxton
    Quote from Dinith88
    I have the winner....

    An 11 year old female w/advanced coronary disease, had been a smoker for 12 years, diabetic for 12 1/2 years...strong family history (both parents died in middle school from MI's.)


    Do you mean she was 21??, both parents where in middle school when they died, or do you mean the patient was in middle school?

    The youngest patient I had was 23, large anterior MI. Was upset because he couldn't eat his daily cheeseburger anymore! Obviously family history was also a factor, his dad had an MI a month after his son! (he was 55)

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