A Case Report of Severe Dehydration Associated With Acute Kidney Injury Causing Acute ST-Segment Elevation Myocardial Infarction

Abstract

The initial electrocardiogram finding in the setting of acute myocardial infarction typically shows either persistent ST-segment elevation or non-ST-segment elevation. In young adults, when coronary angiography is performed, can further classify the patient with an occluded vessel and those with non-occluded coronary arteries. In these subgroups, myocardial infarction can be explained on the basis of coronary artery thrombosis, embolization, spontaneous coronary artery dissection, myocardial bridging, coronary aneurysms, ectasia, anomalous origin of coronary arteries coronary microvascular dysfunction, and vasospasm, or a combination of these factors. We describe a 37-year-old male with a history of chest pain and electrocardiographic evidence of acute myocardial infarction who worked many hours under the sun before being presented to the emergency department. The initial laboratory tests showed evidence of acute kidney injury. He underwent a rescue coronary angiogram due to failed initial medical reperfusion therapy with Tenecteplase, which revealed occluded of the distal left anterior descending (LAD) artery with a minor lesion in proximal LAD and right coronary artery. Our patient experienced acute myocardial infarction owing to severe dehydration. This case is important as it highlights that severe dehydration can be considered one of the triggering factors for acute myocardial infarction in young men who are at risk. Proper hydration could be a preventive measure.