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Review

Myocardial Infarction in Young Adults: A Case Series and Comprehensive Review of Molecular and Clinical Mechanisms

by
Bogdan-Sorin Tudurachi
1,2,
Larisa Anghel
1,2,*,
Andreea Tudurachi
2,
Răzvan-Liviu Zanfirescu
2,3,
Silviu-Gabriel Bîrgoan
1,2,
Radu Andy Sascău
1,2 and
Cristian Stătescu
1,2
1
Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
2
Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
3
Pathophysiology Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
*
Author to whom correspondence should be addressed.
Biomolecules 2025, 15(8), 1065; https://doi.org/10.3390/biom15081065
Submission received: 9 May 2025 / Revised: 15 July 2025 / Accepted: 20 July 2025 / Published: 23 July 2025
(This article belongs to the Special Issue Cardiometabolic Disease: Molecular Basis and Therapeutic Approaches)

Abstract

Acute myocardial infarction (AMI) in young adults, though less common than in older populations, is an emerging clinical concern with increasing incidence and diverse etiologies. Unlike classic atherosclerotic presentations, a significant proportion of AMI cases in individuals under 45 years are due to nonatherothrombotic mechanisms such as coronary vasospasm, spontaneous coronary artery dissection (SCAD), vasculitis, hypercoagulable states, and drug-induced coronary injury. This manuscript aims to explore the multifactorial nature of AMI in young adults through a focused review of current evidence and a series of illustrative clinical cases. We present and analyze four distinct cases of young patients with AMI, each demonstrating different pathophysiological mechanisms and risk profiles—including premature atherosclerosis, substance use, human immunodeficiency virus (HIV)-related coronary disease, and SCAD. Despite the heterogeneity of underlying causes, early diagnosis, individualized management, and aggressive secondary prevention were key to favorable outcomes. Advanced imaging, lipid profiling, and risk factor modification played a central role in guiding therapy. AMI in young adults requires heightened clinical suspicion and a comprehensive, multidisciplinary approach. Early intervention and recognition of nontraditional risk factors are essential to improving outcomes and preventing recurrent events in this vulnerable population.
Keywords: myocardial infarction; young adults; premature atherosclerosis; nonatherosclerotic mechanisms; cardiovascular risk factors; drugs; spontaneous coronary artery dissection myocardial infarction; young adults; premature atherosclerosis; nonatherosclerotic mechanisms; cardiovascular risk factors; drugs; spontaneous coronary artery dissection

Share and Cite

MDPI and ACS Style

Tudurachi, B.-S.; Anghel, L.; Tudurachi, A.; Zanfirescu, R.-L.; Bîrgoan, S.-G.; Sascău, R.A.; Stătescu, C. Myocardial Infarction in Young Adults: A Case Series and Comprehensive Review of Molecular and Clinical Mechanisms. Biomolecules 2025, 15, 1065. https://doi.org/10.3390/biom15081065

AMA Style

Tudurachi B-S, Anghel L, Tudurachi A, Zanfirescu R-L, Bîrgoan S-G, Sascău RA, Stătescu C. Myocardial Infarction in Young Adults: A Case Series and Comprehensive Review of Molecular and Clinical Mechanisms. Biomolecules. 2025; 15(8):1065. https://doi.org/10.3390/biom15081065

Chicago/Turabian Style

Tudurachi, Bogdan-Sorin, Larisa Anghel, Andreea Tudurachi, Răzvan-Liviu Zanfirescu, Silviu-Gabriel Bîrgoan, Radu Andy Sascău, and Cristian Stătescu. 2025. "Myocardial Infarction in Young Adults: A Case Series and Comprehensive Review of Molecular and Clinical Mechanisms" Biomolecules 15, no. 8: 1065. https://doi.org/10.3390/biom15081065

APA Style

Tudurachi, B.-S., Anghel, L., Tudurachi, A., Zanfirescu, R.-L., Bîrgoan, S.-G., Sascău, R. A., & Stătescu, C. (2025). Myocardial Infarction in Young Adults: A Case Series and Comprehensive Review of Molecular and Clinical Mechanisms. Biomolecules, 15(8), 1065. https://doi.org/10.3390/biom15081065

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