Summary

Coronary artery disease (CAD) in the absence of known cardiovascular risk factors is rare. This is the case report of a 42-year-old white female who was admitted with a non-ST segment elevation myocardial infarction (NSTEMI). The patient had seen her general practitioner (GP) in the 2 weeks prior to this with exertional chest pain. She had no known risk factors for cardiovascular disease and other possible underlying aetiologies were ruled out. The patient underwent percutaneous coronary intervention (PCI) to the culprit lesion in the left anterior descending artery. She was discharged on guideline-directed medical therapy and the Dianette contraceptive pill she was taking was stopped. This case serves to remind us that CAD can occur in a variety of patients including premenopausal females and in the absence of known risk factors. It also emphasises that patients presenting with a convincing history of typical angina require prompt investigations, regardless of their apparent level of risk.