Abstract / Summary
Acute ST-elevation myocardial infarction (STEMI) is uncommon in very young adults and may initially present with atypical symptoms, resulting in delayed recognition.Severe complications, such as cardiogenic shock and advanced conduction disturbances, can still occur despite limited conventional cardiovascular risk factors.A 21-year-old man initially presented with epigastric pain and was treated for a presumed gastrointestinal disorder.Further evaluation with electrocardiography later revealed acute anterior STEMI.On admission, he was hypotensive and bradycardic, with cardiogenic shock, complete atrioventricular block (CAVB), and right bundle branch block (RBBB).Coronary angiography demonstrated total occlusion of the left anterior descending artery.A PACE 101 H temporary transvenous pacemaker (Osypka Medical, Berlin, Germany) was inserted before primary percutaneous coronary intervention.Revascularisation using a GuReater CoCr Sirolimus-eluting Coronary Stent System (Lepu Medical Technology (Beijing) Co., Ltd., Beijing, China) successfully restored TIMI grade 3 flow.Following reperfusion, hemodynamic status and atrioventricular conduction improved rapidly, allowing pacemaker removal without permanent pacing.This case shows that extensive anterior STEMI can still occur in very young adults despite limited conventional cardiovascular risk factors.Delayed diagnosis may lead to severe complications, including cardiogenic shock and CAVB.However, timely reperfusion may allow recovery of ischemia-related conduction disturbances without permanent pacemaker implantation.