Coronary Microvascular Dysfunction and Exercise-Induced ST Changes Following Trauma in a Young Adult Born Preterm: A Case Report

Case Report

Volume 5, Issue 4

Coronary Microvascular Dysfunction and Exercise-Induced ST Changes Following Trauma in a Young Adult Born Preterm: A Case Report

Brandon K Eberl¹, Giorgio Manferdelli², Derek A Williams³, Nyal E Borges⁴, Benjamin D Levine^2,5 and Kara N Goss^2,6*

¹Biomedical Engineering, Wake Forest University School of Medicine, USA
²Institute for Exercise and Environmental Medicine, USA
³Pediatric Cardiology, Wake Forest University School of Medicine, USA
⁴Adult Interventional Cardiology, Atrium Health Sanger Heart & Vascular Institute, Charlotte, USA
⁵Cardiology and Internal Medicine, University of Texas Southwestern Medical Center, USA
⁶Pulmonary and Critical Care Medicine, University of Texas Southwestern Medical Center, USA

*Corresponding author: Kara Goss, Pulmonary and Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
E-mail: kara.goss@utsouthwestern.edu

Received: August 21, 2025; Accepted: September 06, 2025; Published: September 15, 2025

Citation: Eberl BK, Manferdelli G, Goss KN, et al. Coronary Microvascular Dysfunction and Exercise-Induced ST Changes Following Trauma in a Young Adult Born Preterm: A Case Report. Case Rep Clin Cardiol J. 2025; 5(4): 163.

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Coronary Microvascular Dysfunction and Exercise-Induced ST Changes Following Trauma in a Young Adult Born Preterm: A Case Report

Abstract

Background: Moderate to extreme preterm birth affects nearly 3% of all live births in the United States and is associated with increased lifetime cardiovascular risk. However, the mechanisms are poorly understood.
Case Summary: A 27-year-old male with history of extreme preterm birth (27 weeks gestation) presented with acute chest pain, dyspnea and exercise intolerance following trauma. When symptoms persisted, exercise testing revealed focal ST depression, prompting coronary evaluation. Left heart catheterization demonstrated decreased coronary flow reserve and adenosine stress MRI demonstrated borderline coronary perfusion reserve, leading to a diagnosis of coronary microvascular dysfunction. Symptoms resolved with isosorbide mononitrate.
Discussion: Extreme preterm birth impairs systemic microvascular development. Impact on the coronary arteries has never been documented but is likely. Coronary microvascular dysfunction should be considered in the differential of chest pain or dyspnea in young adults born preterm, even in the absence of classic risk factors.

Keywords: Coronary microvascular dysfunction; Exercise; Prematurity; Young adults

Article Details

Coronary Microvascular Dysfunction and Exercise-Induced ST Changes Following Trauma in a Young Adult Born Preterm: A Case Report