Endocrine Abstracts

Background: The risk of myocardial infarction among patients with type 1 diabetes is, in addition to traditional cardiovascular disease risk factors, associated with duration of diabetes, reduced glycemic control and renal complications. However, the specific cardiovascular risk predictor models for type 1 diabetes mellitus are subject to many limitations and aggressive macrovascular disease can rarely happen at an early age.

Case Presentation: We report a case of a 22-year-old woman, non-smoker, with a medical history of type 1 diabetes since the age of 4 years old. The glycemic control was not optimal during five years and screening for microvascular complications was negative. Her blood pressure was normal and the lipid profile was within the target with an LDL cholesterol level at 0.6 g/l. She presented an acute chest pain and the electrocardiogram showed a negative T wave in the anterior territory. Echocardiography showed an altered left ventricular ejection fraction of 46% and coronarography revealed an occlusion of the anterior interventricular artery. Angioplasty was successfully performed.

Discussion: The rapidly progressive macrovascular disease observed in this case demonstrates the different degrees of aggressiveness and unpredictable clinical evolution observed in some cases. It also confirms the need for a multi-factorial, early and optimized clinical management regime of type 1 diabetes mellitus.