Case Report:
A 30 years old thin male with a clear medical background presented to the emergency department at Medani Heart Centre (MHC) with central crushing chest pain with maximum intensity radiated to the left shoulder and jaw aggravated by movement and improved by rest not associated with cough or shortness of breath and not improved by ingestion of food or Antacids. The patient denied fever, change in appetite, diarrhea, vomiting, change in urine, headache or any other form of neurological symptoms.
However there was no past history of a similar condition or cardiac problems. The patient mentioned that he is a heavy smoker and has had unprotected sexual intercourse many times. The patient denied drinking alcohol.
On examination the patient looked ill, thin and not pale or jaundiced, pulse 110 regular good volume, Bp100/60 bilaterally, normal pericardium findings, clear chest and soft abdomen. ECG showed Significant ST segment elevation from v1 to v6 and mild elevation in leads 2, 3 and avF confirmed later by positive serum troponin as Late Extensive ST segment elevation Myocardial Infarction crushed by aspirin 300mg, clopidogrel 300 mg, bisoprolol 2,5 mg, Enoxaparin inj. weight  1 kg 12 hourly and the patient was scheduled for urgent Coronary Angiography but during preparation the ICT for HIV tested positively necessitating confirmation with ELISA which showed a high viral load of 22.4 AU/ml (normal up to 1 AU/ml). Other tests revealed normal fasting lipid profile, complete blood count and normal renal function tests with electrolytes.