2023 年 29 巻 2 号 p. 33-37
Heart failure is a leading cause of morbidity and mortality all over the world. Heart failure may present at any age. Young patients present with heart failure of numerous etiologies. Ischemic heart disease, though rare, may also be seen. Early recognition and treatment are therefore crucial, as it might be reversible.
We describe the case of a young patient with familial hypercholesterolemia who presented with severe triple vessel disease and heart failure. The 19-year-old man with a strong family history of coronary artery disease with progressive exertional dyspnea and severe left ventricular dysfunction was diagnosed based on echocardiography. The lipid profile was unusual, with high total serum cholesterol and low-density lipoprotein cholesterol, with normal serum triglycerides. Genetic studies identified variants of low-density lipoprotein receptor and lipoprotein lipase genes. A coronary angiogram revealed severe triple vessel disease. The patient was started on dual antiplatelet and lipid-lowering drug therapy. He underwent a successful coronary artery bypass surgery after which a near-normal left ventricular function was attained. In conclusion, cases involving young patients with familial hypercholesterolemia with severe triple vessel disease presenting with heart failure symptoms are rare; however, early recognition and treatment are crucial for improving the prognosis of both young and adult patients.
