Case studies

A healthy 38-year-old man with premature coronary artery disease

Christian Hamilton-Craig



A fit, nonsmoker who eats well and exercises regularly presents with chest discomfort. Can a healthy individual with no risk factors have severe coronary artery disease?

Key Points

  • When a patient has premature coronary artery disease that is not fully explained by the presence of standard risk factors, it is important to examine him further to ensure no other factors have been missed.
  • New forms of cardiac imagine can be helpful to assess the viability of myocardium to guide decision-making about revascularisation.