Clinical and Angiographic Profile of Acute Coronary Syndrome in Adults Under 40 Years: A Cross-sectional Observational Study

BACKGROUND: Acute coronary syndrome (ACS) in young adults presents unique clinical and diagnostic challenges, with limited data from the Indian subcontinent. AIM: This study aims to assess the clinical profile, risk factors, and diagnostic findings of ACS in adults aged ≤40 years. MATERIALS AND METHODS: This hospital-based, cross-sectional study included 60 patients aged 18-40 with confirmed ACS. Clinical symptoms, laboratory investigations, Electrocardiography (ECG), echocardiography, and coronary angiography were analyzed. Associations were tested using the Chi-square test, with P < 0.05 considered statistically significant. RESULTS: The median age was 35.5 years; 96.7% were males. Breathlessness and palpitations were reported in all cases, while chest pain was present in 81.7%. Hypertension (40%), diabetes (31.7%), smoking (28.3%), and drug use (55%) were common risk factors. Single-vessel disease was the predominant angiographic finding (61.7%). Smoking correlated significantly with ECG abnormalities ( P = 0.0382), and diabetes with severe coronary involvement ( P = 0.0429). CONCLUSIONS: ACS in young adults is more prevalent in males and often presents with nonclassical symptoms. Diabetes and smoking are significantly associated with diagnostic severity. Early risk identification and preventive strategies are essential in this population.