Sudden death associated with silent myocardial infarction in a 35-year-old man: a case report

BACKGROUND Silent myocardial infarction relates to the absence of symptoms usually associated with myocardial ischemia. It has been estimated that silent myocardial infarction can occur in 2-4 % of young adult asymptomatic men. A majority of patients without an initially apparent cause of sudden death have been found at autopsy to have had significant coronary heart disease, including old, undetected myocardial infarction. Cases of sudden death in young men with unrecognized silent myocardial ischemia seem to be underreported, however. CASE PRESENTATION A 35-year-old Norwegian man without a previous medical history died suddenly without preceding symptoms of coronary ischemia. Apart from elevated lactate, his laboratory test results were within normal limits. An autopsy revealed advanced coronary artery thrombosis of the left anterior descending branch with an extensive, partly organized myocardial infarction. The results of toxicological examinations of peripheral blood were negative for usual narcotics and alcohol. CONCLUSIONS Sudden, unexpected death due to myocardial infarction can occur even at a young age in patients without known coronary heart disease.