1. A 21-year-old patient with acute myardical infarction Beijing Anzhen Hospital Capital Medical University Cui song Zhu Xiao-ling

2.  male, 21y,chest pain of four hour onset  The electrocardiogram : ST-segment elevation in the leads I 、 avL and V1-V6  The cardiac enzyme levels  CK1793U/L,CK-MB212ng/ml,cTnI30.29ng/ml General information

3.  Echocardiography : anterior-lateral hypokinesia  blood pressure : 120/85 mmHg, HR:78 beats/min  Heart sounds were normal without a gallop sound or significant murmur.  no cardiac risk factors for coronary artery disease  consistent with acute anterior-lateral myocardial infarction

4.  appropriate treatment was instituted including low-dose aspirin 300mg,100mg,qd  loading-dose clopidogrel 300mg,75mg,qd  5%GS100ml+Diltiazem 20 mg, ivgtt,st  metoprolol,12.5mg.bid,  5%GS100ml+Isosorbide Dinitrate 30mg,ivgtt  Clexane 60mg,ih,q12h  Enalapril,2.5mg ， qd  Simvastatin, 10mg ， qn  Tirofiban,7ml/h,24h,ivgtt

5. Admission ECG

6. 2 hours after of admission

7. Urgent diagnostic coronary angiography

10. 17 days diagnostic coronary angiography

11. 17 days ECG

12. Question  Do all yang patients with acute mycardical infarction need PCI ?  Statins have been applied?  The pathogenesis of this case?