title: Right Coronary Dissection and Left Anterior Descending Thrombus: Dual Dilemma in a Young Cardiac Arrest Survivor.
abstract: BACKGROUND
  ST-elevation myocardial infarction (STEMI) leading to cardiac arrest is an exceptionally rare occurrence in young adults. Those affected tend to abuse sympathomimetic drugs, have strong family histories, or have a significant burden of cardiac risk factors. Another uncommon cause of STEMI is coronary artery dissection, which overwhelmingly affects middle- and older-aged women with few cardiac risk factors.
  
  
  METHODS
  A 22-year-old athlete with no medical history was admitted to our institution post-cardiac arrest with an anterior STEMI and concomitant right coronary dissection. To our knowledge, this represents the first documented case of these simultaneous pathologies in a young cardiac arrest survivor. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Myocardial infarction is rare in young adults, and a diverse range of etiologies must be considered promptly to prevent delays in time-sensitive therapies, such as antiplatelet agents and revascularization. The emergency physician is most often the first point of contact in patients with acute coronary syndromes, and the failure to recognize it in young adults threatens them with premature death and potentially life-long disability.
authors.affiliation: Department of Cardiology, Fiona Stanley Hospital, Perth, Australia.
authors.forename: Holly
authors.initials: H
authors.lastname: Morgan
authors.affiliation: Department of Cardiology, Fiona Stanley Hospital, Perth, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: McCann
authors.affiliation: Department of Cardiology, Fiona Stanley Hospital, Perth, Australia.
authors.forename: Alan
authors.initials: A
authors.lastname: Whelan
authors.affiliation: Department of Cardiology, Fiona Stanley Hospital, Perth, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Clugston
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D017023:Coronary Angiography / Q000379:methods; D003327:Coronary Disease / Q000150:complications; D004562:Electrocardiography / Q000379:methods; D004636:Emergency Service, Hospital / Q000458:organization & administration; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000379:methods; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy*; D017741:Survivors; D013927:Thrombosis / Q000150:complications; D055815:Young Adult
keywords: STEMI; athlete; cardiac arrest; coronary dissection; myocardial infarction; young