Among patients presenting with acute myocardial infarction (AMI), the proportion of young individuals has increased in recent years. Although coronary atherosclerosis is less extensive in young patients with AMI, with higher prevalence of single-vessel disease and rare left main involvement, the long-term prognosis is not benign. Young patients with AMI with obstructive coronary artery disease have similar risk factors as older patients except for higher prevalence of smoking, lipid disorders, and family history of premature coronary artery disease, and lower prevalence of diabetes mellitus and hypertension. Smoking cessation is by far the most effective secondary preventive measure. Myocardial infarction with nonobstructive coronary arteries is a relatively common clinical entity (10%-20%) among young patients with AMI, with intravascular and cardiac magnetic resonance imaging being key for diagnosis and potentially treatment. Spontaneous coronary artery dissection is a frequent pathogenetic mechanism of AMI among young women, requiring a high degree of suspicion, especially in the peripartum period.

近年来，在急性心肌梗死（AMI）患者中，年轻人的比例有所增加。尽管年轻 AMI 患者冠状动脉粥样硬化的范围较小，单支病变的患病率较高，左主干受累较少，但其长期预后并不好。患有阻塞性冠状动脉疾病的年轻 AMI 患者与老年患者具有相似的危险因素，但吸烟、血脂异常和早发冠状动脉疾病家族史的患病率较高，糖尿病和高血压的患病率较低。戒烟是迄今为止最有效的二级预防措施。在年轻的 AMI 患者中，伴有非阻塞性冠状动脉的心肌梗死是一种相对常见的临床疾病（10%-20%），血管内和心脏磁共振成像是诊断和潜在治疗的关键。自发性冠状动脉夹层是年轻女性 AMI 的常见发病机制，需要高度怀疑，尤其是在围产期。