Severe Multivessel Coronary Artery Disease in an Adolescent With Genetic Dyslipidemia.

BackgroundFamilial hypercholesterolemia is characterized by lifelong elevations in low-density lipoprotein cholesterol (LDL-C) that, when left untreated, markedly increase the risk of premature atherosclerotic cardiovascular disease (ASCVD). Although ASCVD is common in adults with familial hypercholesterolemia, events in adolescence are rare.Case summaryA 14-year-old man presented with exertional chest pain and mild troponin elevation. Myocarditis was initially suspected, but the persistence of symptoms prompted advanced imaging, revealing multivessel ASCVD. LDL-C was severely elevated (9 mmol/L, 350 mg/dL). Atorvastatin and ezetimibe lowered LDL-C to ≤1.4 mmol/L (