There are only few publications and studies related to larger cohorts of patients with acute coronary syndromes at a young age that have been published so far. Majority of authors chose the limit of ≤ 45 years for the „youth“. Young patients represent 3-10 % of all patients with an acute myocardial infarction. Younger patients showed higher rates of smoking (up to 92 %), obesity, dyslipidemia and a positive family history (39 %) than the elder ones. Acute coronary syndromes in young patients is often the first presentation of ischemic heart disease mostly with a better outcome than in elder patients. The time plays the key role in all of patients with an early reperfusion predicting their further outcome.