Background: Acute coronary syndrome refers to a spectrum of clinical presentations ranging from those for ST-segment elevation myocardial infarction (STEMI) to presentations found in non-STEMI or unstable angina.
Case presentation: We present a case of a 36-year-old female who visited cardiac outdoor patient department with continuous left arm pain. She was then referred to nuclear cardiology for screening of coronary artery disease (CAD). A pharmacological stress study was planned but the rest study was done instead due to the patient having persistent pain in the left arm. The rest study showed a large perfusion defect in left anterior descending artery (LAD) territory. As the patient was not having any previous history of CAD except for positive family history of premature CAD, she was immediately referred to an interventional cardiologist where her primary percutaneous coronary revascularization to LAD (3 × drug eluting stent) got done and she was saved from impending MI.
Conclusion: Regular follow-up and monitoring should be fine in young adults with a positive family history of premature CAD. This may help in early detection leading to time management and acute coronary events in young adults may be avoided. This will eventually reduce mortality and morbidity.
Key words: Myocardial perfusion imaging, premature coronary artery disease, LAD territory, PCI, Myocardial ischemia, Perfusion defect
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