Rohan Sharma, a 21-year-old young man from Delhi, had lost his father early in life and was the only support for his mother. He worked hard in a private job, but like many young adults, he had become a regular smoker and had recently been diagnosed with diabetes. He never imagined that these habits would put his young heart at such risk.
On a fateful day in early 2026, Rohan suddenly developed severe chest pain. Within a short time, he was brought to the Emergency Department in distress. His ECG showed a massive Anterior Wall STEMI. He was already in pulmonary edema, struggling to breathe, with low oxygen levels and falling blood pressure.
Dr. Jogendra Singh immediately shifted him to the Cath Lab for emergency angiography. The images were shocking for such a young patient — ostial LAD showed thrombotic occlusion with a huge thrombus burden. The clot was massive and unstable.
Initial balloon dilatation was attempted, but the thrombus did not clear. Manual thrombus aspiration was performed, yet during the procedure, the patient suddenly developed VT/VF cardiac arrest. The thrombus fragmented and migrated to the Left Main Coronary Artery (LMCA) and extended towards the LCx. Rohan collapsed on the table. The team immediately intubated him and started CPR.
In this critical moment, intracoronary antiplatelet agents (GP IIb/IIIa inhibitors) were urgently administered directly into the coronary arteries. With persistent aspiration and repeated attempts, the thrombus was finally cleared from the LMCA and LCx. A drug-eluting stent was successfully deployed in the proximal LAD, restoring TIMI III flow.
Rohan was kept on ventilator support and aggressive medical therapy in the Cardiac ICU. For the next three days, the team worked tirelessly to stabilize his heart function, manage pulmonary edema, and control blood sugar. To everyone’s relief, he gradually improved. He was extubated, stabilized, and discharged after proper counselling on smoking cessation, diabetes control, and medication adherence.
Now, several months later, Rohan is doing remarkably well. He has completely quit smoking, is managing his diabetes with diet and medicines, and has returned to his normal routine. He visits the OPD with his mother, smiling and full of gratitude. His heart function has significantly improved, and he has no chest pain or breathlessness.
With tears in his eyes, Rohan says:
“Doctor sahab, I am only 21… I lost my father early, and I thought my mother would lose me too that day. But you and your team brought me back from death. I have got a second life. I will never smoke again and will take care of my mother and my health.”
This extraordinary case of a 21-year-old with massive STEMI, pulmonary edema, and catastrophic thrombus migration to LMCA-LCx highlights that heart attacks do not spare the young. Rapid decision-making, advanced thrombus management, intracoronary pharmacotherapy, and team effort can save even the most challenging cases.
A powerful lesson for all young smokers and diabetics — never ignore chest pain.
Dr. Jogendra Singh
Senior Consultant Interventional Cardiologist
AIIMS Gold Medallist
Senior Consultant
Department of cardiology
Sant Parmanand Hospital Kashmere gate Delhi
