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Acute chest pain in a young man with low cardiovascular risk profile
  1. Jasper Boeddinghaus1,2,
  2. Andrew R Chapman1,2,
  3. Peter A Henriksen1
  1. 1 Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK
  2. 2 BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Jasper Boeddinghaus, Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, UK; Jasper.Boeddinghaus{at}usb.ch

https://doi.org/10.1136/heartjnl-2023-323398

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    Clinical introduction

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    A man in his 40s presented to our emergency department with sudden onset of severe central chest pain radiating to his left arm. He was sweaty, clammy and had accompanying breathlessness. There was no antecedent angina. His cardiovascular risk profile was low except for being a smoker (15 cigarettes per day). There was no medical history and he was not on any medical treatment.

    The 12-lead ECG showed sinus rhythm with hyperacute T waves in leads V3 and V4. Coronary angiography was performed using right radial access. The right coronary artery was small and free of disease. The left system showed no disease in the left main stem, but mild plaque disease in the dominant left circumflex artery. Angiographic findings of …

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    Footnotes

    • Twitter @J_Boeddinghaus, @chapdoc1

    • Contributors JB and PAH performed the invasive diagnostic and treatment of the patient. JB and ARC wrote the case report. PAH revised the manuscript critically and approved the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.