TY - JOUR T1 - Acute myocardial infarction in a young patient with triple valve replacement JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2020-240732 VL - 14 IS - 7 SP - e240732 AU - Yash Paul Sharma AU - Krishna Prasad AU - Nitin Patel AU - Prashant Kumar Panda Y1 - 2021/07/01 UR - http://casereports.bmj.com/content/14/7/e240732.abstract N2 - Rheumatic heart disease is an important cause of mortality and morbidity in developing countries, and is the leading cause of triple valve replacement. Myocardial infarction (MI) in such cases can be due to the coronary embolism from the prosthetic valves or due to atherosclerotic vascular disease. Intravascular imaging helps in delineating the cause. We present a case of a 34-year-old premenopausal woman with no conventional cardiovascular risk factors and had triple valve replacement 4 years ago and anterior wall MI with cardiogenic shock and left ventricular failure. She was managed with mechanical ventilation, thrombolysis, diuretics, double antiplatelets and anticoagulation with low molecular weight heparin. Intravascular ultrasound showed a lipid-rich plaque with associated plaque rupture and thrombosis. Intravascular imaging helps in delineating the cause of MI and further management. Atherosclerotic MI in a patient with no conventional risk factors is rare and needs to be considered. ER -