ArticleJACC. Case reports2025
Left Main Angioplasty for Acute Coronary Syndrome in 7-Year-Old Girl With Familial Hypercholesterolemia.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFamilial hypercholesterolemia is a genetic disorder caused by mutations in low-density lipoprotein receptor, resulting in markedly elevated low-density lipoprotein cholesterol, premature atherosclerosis, and xanthomas. CASE SUMMARY: We present a case of a 7-year-old girl with homozygous familial hypercholesterolemia, who developed acute coronary syndrome. Coronary angiography revealed critical ostial and mid-shaft left main (LM) stenosis. She underwent LM intravascular ultrasound-guided percutaneous coronary angioplasty (PTCA) with a drug-eluting stent. She also had mild supravalvular aortic stenosis, which warrants ongoing follow-up. DISCUSSION: PTCA in pediatric patients is technically challenging. Revascularization strategy can best be determined on a case-to-case basis. This case highlights that with careful planning, LM PTCA can be feasible and life-saving in select pediatric patients. TAKE-HOME MESSAGES: Pediatric patients with familial hypercholesterolemia require a high index of suspicion for coronary artery disease. Revascularization decision is challenging in pediatric patients due to lack of data, and long-term outcomes remain uncertain.
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