What Triggers A Heart Attack In The Young? Is It Different For Men & Women?

What triggers a heart attack in the young?

There has been an increase in the number of cases that we see in our outpatient cardiology department for the last few years. More and more patients between the age of 20 and 30 years come with heart problems: the reason is diabetes which is a major risk factor in these patients. There are many patients who come with hypertension and the reason is exposure to excessive stress and strain in life. Being overweight and obese, having junk food, and not doing much exercise are other reasons which have increased the incidence of heart attacks. 

We have seen an exponential rise in the incidence of heart attacks in cigarette smokers. And even electronic cigarettes are not free of problems, they are a major risk factor. Your heart attacks are directly proportional to the number of cigarettes you smoke. Smoking one pack a day doubles your risk of heart attacks compared to nonsmokers. While we have a misconception that smoking or vaping does not cause much of a problem. The problem is that very little is known about these things and very few people know that even an electronic cigarette is a health hazard and leads to serious heart problems. 34% of the patients who smoke electronic cigarettes may have a heart attack as compared to non-smokers.

What triggers a heart attack in women?

There is something called SCAD which is spontaneous coronary artery dissection. It is responsible for more than 35% of females having heart attacks below the age of 50 years. Now, it seems that the age has been reduced to 42 years. The risk factors include recent childbirth, underlying blood vessel conditions like fibromuscular dysplasia, hereditary connective tissue disorders, and high blood pressure. I would say SCAD is more likely the cause these days. Almost 43% of females do not experience chest pain as the first symptom of a heart attack. This is something very important. It is often only fatigue that goes unrecognized, back pain or shoulder pain, pain in shoulder blades, there may be a pain in both the arms, stomach pain, and abdominal discomforts like indigestion or unexplained fatigue and weakness. So, for females, we have to be very careful in analyzing heart attack symptoms.

Are the symptoms different?

A regular heart attack patient experiences symptoms like severe chest pain, which is squeezing in nature radiating to the left arm, shortness of breath, and sweating. And sometimes they may also experience symptoms like upper abdominal pain, and pain in the jaw which usually increases with exercise and is relieved by rest. It is more after heavy meals and if a patient climbs stairs. So, these are classical symptoms of chest pain during a meal whereas in females the symptoms are different.

(Dr. Ajay Kaul - Chairman, Cardiac Sciences, Fortis Hospital Noida)

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