Rationale: Acute myocardial infarction (AMI) in young individuals has become increasingly prevalent in recent years, with the age of onset progressively declining. According to the China Acute Myocardial Infarction Registry, which included over 24,000 cases, approximately 8.5% of AMI patients were aged ≤45 years. However, AMI occurring in adolescents remains exceptionally rare. Early recognition and timely intervention in such patients pose significant clinical challenges and carry important implications for improving outcomes in this population. Patient concerns: We report the case of a 16-year-old previously healthy male who presented with persistent precordial pain lasting over 4 hours. On admission, an emergency electrocardiogram showed atrial fibrillation with a heart rate of 117 bpm, abnormal Q waves in leads I, aVL, V2, and V3, and ST segment elevations ranging from 0.1 to 0.8 mV in leads I, aVL, and V1–V5. Diagnoses: Based on clinical presentation and ECG findings, the patient was diagnosed with acute extensive anterior and high lateral wall myocardial infarction. Interventions: Emergency coronary angiography revealed total occlusion of the left main coronary artery. The patient was immediately treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) and received comprehensive supportive care. Outcomes: Despite aggressive intervention, the patient developed catastrophic intracranial hemorrhage and subsequently died. Lessons: This case highlights the importance of considering AMI in the differential diagnosis of chest pain even in adolescents, and underscores the need for heightened clinical awareness, early diagnostic evaluation, and rapid therapeutic decision-making. Further research is needed to understand the underlying mechanisms and risk factors contributing to early-onset AMI in young individuals.
Xie et al. (2025) studied this question.