Chest Pain in Young Adults; Acute Myocardial Infarction vs. Non-Coronary Chest Pain in the Emergency Setting
Mitsungnern T, MD1, Kotruchin P, MD, PhD1
Affiliation : 1 Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : There has been an increasing number of young adults who presented at the emergency room (ER) with chest pain.
Although it is uncommon for coronary disease to be the etiology chest pain in young adults, every patient who presents with chest
pain should be considered as a potentially serious condition. Therefore, knowing the differential characteristics between young
adults with chest pain due to acute myocardial infarction (AMI) and young adults with non-coronary chest pain might help
differentiating between the two groups.
Objective : To study the differential characteristics between young adults who visited ER with chest pain due to AMI and the non-
coronary chest pain and to determine factors that associated with AMI in young adults.
Materials and Methods: A retrospective descriptive study conducted at the emergency department, Srinagarind Hospital,
Khon Kaen, Thailand. Clinical data of patients aged 15 to 44 years old who presented with chest pain and were admitted to
the hospital were collected. The patients were classified into two groups 1) AMI group and 2) Non-coronary chest pain group.
The clinical characteristics between the two groups were compared. Clinical risk factors of AMI were studied.
Results : There were 52 and 76 patients in the AMI and the non-coronary chest pain group. Patients in the AMI group were older,
39.6+4.0 vs. 30.3+9.7 years old (p<0.001), had higher body mass index (BMI), higher diabetes mellitus (DM), dyslipidemia, and
smoking (all p<0.001). The AMI group had higher blood sugar, and cholesterol (167.8+99.2 mg/dl vs. 119.1+55.0 mg/dl, p = 0.012
and 204.9+90.2 mg/dl vs. 171.0+72.0 mg/dl, p = 0.035). Dyslipidemia, smoking, and age 35 to 44 years old were independently
associated with AMI (OR 54.8, 95% CI 9.9 to 303.1, OR 22.2, 95% CI 3.0 to 162.5, and OR 17.3, 95% CI 2.3 to 128.6, respectively).
Conclusion : Young adults with AMI tended to have metabolic risk factors such as DM, dyslipidemia, and smoking. Furthermore, the
conventional metabolic risk factors such as dyslipidemia, smoking, and increasing age were found to be independent risk factors
of AMI in the young adults.
Keywords : Acute coronary syndrome, Young patients, Emergency, Angina, Thai
