A 26 year old patient died as a consequence of myocardial infarction in the presence of witnesses.Two weeks earlier he had visited his family doctor because pain in his shoulder and left arm, which was diagnosed as muscular strain for which the patient was recommended to place his arm in a sling.The pathological study showed the existence of a myocardial infarct in the interventricular septum and the scar was two weeks old. The left circumflex coronary and the anterior descending arteries, presented severe atheromatous stenosis, of more than 90%. Among the points of interest in the family history, the existence of two episodes of myocardial infarction with hospitalization in the Intensive Care Unit of the victim's elder brother, aged 32 years, due to a myocardial infarct and the death of a first cousin - 28 years old - also due to myocardial infarction, were significant. Given the youth of the deceased and his family history, the convenience of carrying out a lipid study was suggested to the family, in view of the suspicion of possible familial hiperlipidaemia.The results of the autopsy, together with the family history, the biochemical and the lipid study carried out pointed to the existence of a Combined Primary Familial Hiperlipidaemia. Other possibility to explain the severe atheromatous lesions found in this case would be the existence of a abnormal elevation of Lipoprotein (a) ( > 0.3 g/L) considered by numerous authors an independent risk factor to have conditioned the apparition of a severe atherosclerotic coronariopathy and sudden cardiac death in young people. In Spain, the Foundation named "Hipercolesterolemia Familiar" edits a paper with information and advices for persons which suffers lipid metabolic disorders (http://www.colesterolfamiliar.com/).
Foto nº 6.- Las flechas delimitan una zona, localizada en el septum interventicular, de aspecto blanquecino.Prof.Garfia.