Trans people are defined as those who present discrepancy between the assigned gender and self percieved or constructed gender as the International Labour Organization defines. According to the 2022 National Census of Population, Housing, and Households, Argentina recorded 196,956 people who do not identify with the sex registered at birth, representing 0.4% of the total population in private households. This case discusses a 24-year-old trans male patient with a medical history of smoking, obesity, and problematic substance abuse (marijuana and cocaine) began testosterone therapy for gender affirmation in 2021. He was vaccinated against COVID-19 with two doses of Sinopharm. In March 2024, he experienced short episodes of oppressive precordial pain. After two more episodes, a cardiologist found normal EKG and echocardiogram results. In June, he had severe typical precordial pain requiring ICU admission, later on he presents with STEMI. Coronary angiography revealed subocclusion and occlusion in the left anterior descending artery, treated with angioplasty and stenting. A right coronary artery dissection was later detected and treated with two additional stents. Cardiac MRI showed preserved ejection fraction, necrosis at both ventricles apex, and no thrombi. After eight days of hospitalization, he was discharged. Follow-up MRI showed no changes, thrombophilia and antiphospholipid syndrome were discarded, and the patient continues multidisciplinary follow-up  planning to restart hormone therapy. Research on hormone therapy's effects on cardiovascular health in transgender individuals is in its early stages. Identifying disparities in cardiovascular risk factors highlights the need for improved risk stratification, not yet defined in guidelines. Studies like calcium scoring, Lp(a), coronary angiotomography, and arterial Doppler should be used for early detection of cardiovascular disease. The impact of testosterone therapy, particularly on thrombotic events and coronary dysfunction, requires further study. A multidisciplinary approach, including endocrinology and hematology specialists, is essential for comprehensive care.

Mariela Huertas is a medical doctor who graduated from the National University of Comahue (UNCo), Argentina. During her studies, she demonstrated strong academic commitment by serving as an ad honorem teaching assistant in Human Physiology at the University of Medical Sciences. Her passion for research and medical practice is evident in her publication “Dilated Cardiomyopathy and Duchenne Muscular Dystrophy” in the prestigious Argentine Journal of Cardiology (2024), a significant contribution to understanding this complex condition. Currently, she is in her fourth year of residency in Cardiology, a stage where she has shown herself to be a proactive professional committed to providing high-quality medical care. Her dedication and talent were recently recognized when she was awarded the title of "Young Cardiologist 2024" by the Latin American Society of Interventional Cardiology, an honor that highlights her growing impact in the field of cardiology and her international projection. With a clear focus on excellence, Mariela remains committed to professional growth and contributing to the medical-scientific field. She continuously seeks opportunities for learning and collaboration that enable her to enrich clinical practice and contribute to improving patients' quality of life.