Heart Attack Risks in Young People

Although the risk of heart attack (myocardial infarction, or MI) in young people is relatively low, between 4% and 10% of heart attacks occur in those under 45. For some, the same lifestyle factors known to contribute to MI in people of all ages, such as diabetes, obesity, smoking, and being sedentary, often are at least partially involved.

A woman touching her chest in pain
 

At the same time, there are a handful of lesser-known risk factors for MI that are associated with heart attacks experienced by young people. If you're "too young" to have a heart attack, the chances you'll have one are extremely low. Even so, it can't hurt to know about the few risk factors that apply to younger people, as well as any measures that can be taken to help prevent an MI.

Lifestyle

The overall risk factors for a heart attack are well known, but bear repeating, given that some that once applied mostly to older people are increasingly applicable to the young.

In particular, type 2 diabetes—which often results from poor diet, inactivity, and being overweight or obese —and hypertension (high blood pressure) are increasingly associated with early heart attack risk.

In a 2018 review of more than 28,000 people hospitalized for a heart attack between 1995 to 2014, 30% were between 35 to 54 (considered young for the purpose of the study). What's more, the prevalence of hypertension and diabetes has increased in this younger group. These conditions were observed more often in women than in men.

If you're worried about exercising too much, that's a concern you can generally rule out. There have been a few reports that extreme endurance exercise may lead to the development of scar tissue in the heart, even in young people. However, doctors don't know yet exactly what the scarring (fibrosis) means, and there is currently no significant data to suggest it can cause a cardiac event.

Furthermore, heart attacks are not a common cause of sudden cardiac death in young people. Overall, there are many more studies that show exercise prolongs life and reduces the risk of cardiac issues.

Spontaneous Coronary Artery Dissection

Spontaneous coronary artery dissection (SCAD) is now recognized as an important cause of heart attack and sudden death in young women, as well as men without other risk factors for atherosclerosis. In this syndrome, there is a spontaneous tearing of the coronary artery wall, which blocks blood flow to the heart muscle. It may be the cause of up to 35% of myocardial infarctions in women 50 and under, as well as the most common cause of myocardial infarction associated with pregnancy.

The underlying causes of SCAD are still theoretical. Those with the condition do not have atherosclerosis, but may have a condition called fibromuscular dysplasia in which there is abnormal growth of cells in the arteries. Hormonal factors, inflammatory conditions, and environmental and genetic factors may be involved as well.

Heart Abnormalities

Heart abnormalities are a risk factor for sudden cardiac death and heart attack in young people. Two such conditions are:

  • Hypertrophic cardiomyopathy, an inherited condition characterized by enlargement of heart muscle cells that causes the walls of the ventricles to thicken. It is currently believed to be the most common cause of sudden cardiac death in young athletes, though other conditions can also cause a heart attack in this population.
  • Kawasaki disease, a rare childhood disorder, causes acute inflammation of blood vessels. When coronary arteries are affected, the heart may be deprived of oxygen-rich blood, leading to tachycardia (an abnormally rapid heart rate), cardiac inflammation, and heart failure.

A Word From Verywell

The prevention of heart disease in young people means taking the same measures recommended for older adults: following a healthy diet, getting regular exercise and routine medical check-ups, achieving weight control, and smoking cessation. However, there is growing concern that the message isn't reaching younger age groups.

The American Heart Association's Go Red for Women campaign seeks to raise awareness that heart disease is the leading cause of death in women.

To find those at risk for sudden cardiac death, many NCAA colleges require cardiac screening for student athletes. This includes a review of the athlete's cardiac risk factors, blood pressure, heart-related symptoms, and family history as well as other in-office exams. The evaluation is meant to flag individuals in need of referrals to a cardiologist for further testing, which may include an electrocardiogram (ECG) or cardiac ultrasound (echocardiogram). Some health officials think this could be beneficial for high school athletes as well.

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