Cinecoronary Arteriography in Young Men

Of a group of 723 men less than 40 years old who underwent cinecoronary arteriography primarily for evaluation of chest pain, 357 (49%) were found to have at least 50% narrowing of one or more coronary arteries. The youngest person was 17 years old. The distribution of lesions in the young men was similar to that found earlier in a study of persons not selected by age. The anterior descending coronary artery was most frequently affected; the right coronary artery was most often totally occluded. No total occlusions of the left main coronary artery were seen. Electrocardiographic evidence of myocardial infarction, found in 109 patients, was less common with disease of the circumflex or right coronary arteries than with disease of the anterior descending coronary artery. This observation was confirmed by examination of left ventriculograms for areas of decreased contractility. Six patients had no significant arterial narrowing. The extent of arterial involvement seemed to be related to the duration of symptoms in patients who had angina pectoris or myocardial infarctions. Clinical diagnoses correlated well with the angiographic findings, particularly in those men considered to be normal and those with typical angina pectoris. Addition of atypical features or prolonged pain decreased the degree of correlation. Only 20% of those with cholesterol levels less than 200 mg/100 ml had significant lesions, whereas 81% with levels more than 275 mg/100 ml had such findings.