Most people find heart attacks to be something that only occurs in older individuals in their 60s and above, especially those with pre-existing health problems. However, in recent times, the surge of heart attacks among youths has been making headlines and has raised alarm. In fact, a study conducted in 2019 presented at the American College of Cardiology revealed that over 20% of all heart attacks in the U.S. occur in people under 40 years old.
It may seem surprising that a healthy, active person in their 20s could suffer a heart attack, yet emerging data suggests otherwise. Are these heart attacks preventable? Read on to explore the causes and risk factors behind this unsettling trend, along with the steps to protect yourself.
What Causes Heart Attacks in Young People?
A heart attack, or myocardial infarction, is a state of heart muscle blockage by blood. A blockage of blood flow means that the heart tissue may start to die. But what causes a heart attack in young adults? The older adults typically suffer from this due to a combination of aging, lifestyle, and genes. Teenagers can also be at risk from conditions such as poor diet, no exercise, stress, smoking, drug abuse, and even certain health conditions or family history. Some of these you can change, and some you can’t, but becoming aware of them is the beginning. Let’s examine these conditions below:
Atherosclerosis (Plaque Build-Up)
Atherosclerosis is more prevalent in older age, but its onset starts in childhood and can progress in some people based on lifestyle. Atherosclerosis consists of the accumulation of cholesterol, fat, and other elements along the walls of the arteries, forming plaques that can limit or stop blood flow to the heart. In young adults, plaque development can grow quickly in some individuals in their 20s and 30s. While in older adults, more advanced atherosclerosis and its complications more frequently occur after age 40 to 50, as the disease is accelerated and symptoms become apparent.
In younger adults, this can be exacerbated by dietary deficiencies, physical inactivity, smoking, or heredity. This continual accumulation of plaque within the arteries can eventually burst, with a clot forming and potentially resulting in a heart attack.
Coronary Artery Spasm
Not all heart attacks in the young are due to atherosclerosis. Occasionally, coronary artery spasm due to the sudden constriction of the arteries happens. The spasm reduces blood supply to the heart and may result in heart attacks. It is frequently due to drug abuse, which causes severe spasms of the coronary arteries.
Even without drug use, stress, cold temperatures, or some medications may cause spasms in the arteries, leading to heart attack-like symptoms. It may be more prevalent in younger people who experience more stress or other environmental stimuli.
For example, pseudoephedrine acts on alpha and beta adrenergic receptors, which cause constriction of blood vessels in the body, including coronary arteries. It can decrease coronary artery blood flow to the heart muscle and, in a few people, induce coronary artery spasm, causing chest pain, high blood pressure, irregular heart rhythms, or even a heart attack.
Genetic Factors: Inherited Conditions
Genetics has a tremendous influence on heart health, and certain young individuals can have inherited conditions that increase their risk. An example is familial hypercholesterolemia, a condition that leads to extremely high levels of cholesterol at a young age, resulting in the premature development of atherosclerosis and predisposing to heart attack. Other inherited diseases, including Long QT syndrome, interfere with the regular rhythm of the heart, resulting in sudden cardiac arrest or heart attacks.
Inflammation and Autoimmune Disorders
Recurrent or chronic inflammation from diseases such as autoimmune disorders (e.g., rheumatoid arthritis or lupus) or even gum disease can induce heart attacks at 25. Chronic inflammation may be responsible for the formation of plaques in the arteries, weakening the vessels and predisposing them to rupture.
Medical professionals utilize C-reactive protein (CRP) levels, which are assessed by a blood test, to evaluate for body inflammation and estimate an individual’s risk for heart disease. High CRP levels reflect low-grade inflammation of the blood vessels and are linked with increased risk of atherosclerosis and future cardiovascular events.
Additionally, diseases such as diabetes and hypertension (high blood pressure) are usually undiagnosed among youth, particularly those who do not have frequent checkups. Even a mild case of these diseases can lead to heart disease and raise the likelihood of heart attacks at a young age.
Blood Clotting Disorders
In rare cases, young people who have inherited blood clotting disorders are more likely to experience clot formation in the arteries, which can lead to heart attacks. Conditions like factor V Leiden or antiphospholipid syndrome, and Prothrombin G20210A mutation cause the blood to clot excessively, increasing the risk of blockages in the coronary arteries.
Long QT Syndrome
Long QT syndrome impacts the electrical system of your heart, so that it takes longer than normal to recover between beats. Normally, your heart has a very specific rhythm. But with Long QT syndrome, the heart’s electrical system is slow, causing irregular heart rhythms, particularly with physical activity or stress.
They may cause a wild, runaway heartbeat that interferes with the heart’s capacity to pump blood efficiently, and causes cardiac arrest, in which the heart just stops. Long QT syndrome can be diagnosed by an electrocardiogram (ECG or EKG), which takes a measurement of the QT interval. It is the duration of time that the heart’s ventricles take to depolarize and repolarize on every beat. If the corrected QT interval exceeds 450–460 milliseconds, long QT syndrome is present.
Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy (HCM) is a genetic disorder in which the heart muscle is abnormally thickened, particularly in the left ventricle, which pumps blood to the rest of the body. You may not experience anything different at first, but the thickened muscle will interfere with the blood flow. It becomes harder for your heart to pump blood efficiently, especially during physical activity when your body needs more oxygen-rich blood. Over time, it will increase the risk of ventricular arrhythmia, an abnormal heart rhythm that can lead to sudden cardiac arrest.
Forceful Hit to the Chest
A forceful blow to the chest, which happens in contact sports, can cause a rare but serious condition called commotio cordis. It happens when one is struck hard in the chest, usually in the moment when the heart is beating. This sudden blow may lead to an electrical disruption in the heart. The hit might not seem that intense, but if it lands at the precise moment when your heart is in a vulnerable state of its rhythm, it can stop the heart in its tracks.
The electrical shock from the impact causes the heart to lose its normal rhythm, and if not treated immediately, this can lead to sudden cardiac arrest. Commotio cordis has become more recognized in recent years, especially following high-profile football incidents, and highlights the importance of rapid CPR and defibrillation in saving lives.
Risk Factors for Heart Attacks in Young People
Now that we’ve explored what causes cardiac arrest in young adults, let’s look at the risk factors. Heart disease is often associated with older individuals, those who’ve accumulated decades of unhealthy habits. But the reality is different. More young people are experiencing heart attacks at alarming rates.
You might be wondering, what’s behind this disturbing shift? Are young people living unhealthier lives, or is something else at play here? Let’s break it down.
1. Obesity and Overweight
Obesity is one of the biggest risk factors for heart attack in the 20s, and it has become increasingly prevalent among younger populations. According to the Centers for Disease Control and Prevention (CDC), 40.3% of American adults are obese. The main concern is visceral fat, stored deep around internal organs. It drives inflammation, increases cholesterol, raises blood pressure, and promotes insulin resistance, which heightens the risk of heart attacks. The rise of processed foods and sedentary lifestyles in younger generations has contributed significantly to this issue.
2. Vaping
Vaping, especially with nicotine-containing e-cigarettes, can cause immediate increases in both blood pressure and heart rate in young users. After vaping, studies in NIH show that systolic and diastolic blood pressure can rise, and heart rate can increase by roughly 4 beats per minute, with these effects lasting up to 20 minutes after use. This happens because nicotine stimulates the sympathetic nervous system, leading to blood vessel constriction and increased cardiac workload. Over time, repeated spikes in blood pressure and heart rate may contribute to a higher risk of cardiovascular disease, even in young adults.
3. Physical Inactivity
In today’s digital age, young people are spending more time sitting than ever before. Whether it’s working from home, attending school online, or binge-watching TV, a lack of physical activity is becoming a major issue. The World Health Organization (WHO) warns that 1 in 4 adults globally is insufficiently active, which increases the risk of heart disease and stroke.
4. Chronic Stress and Mental Health Issues
Can young people have heart attacks even when they don’t have any prior medical conditions? Yes! Chronic stress, anxiety, and depression are all too common among young people today. The American Psychological Association reports that nearly 76% of adults experience significant levels of stress. This constant stress triggers the release of hormones like cortisol and adrenaline, which can cause inflammation, increase blood pressure, and increase the risk of heart disease.
Moreover, mental health conditions can lead to unhealthy coping mechanisms like smoking, drinking, or overeating, all of which exacerbate heart disease risks. Just 5–10 minutes a day of mindfulness meditation or slow, deep breathing can lower stress hormones and help regulate your heart rate and blood pressure.
5. High Blood Pressure (Hypertension)
High blood pressure is often referred to as the “silent killer” because it usually doesn’t have obvious symptoms but can have devastating effects on the heart. Untreated hypertension causes wear and tear on the arteries, leading to arteriosclerosis (hardening of the arteries) and an increased risk of heart attacks. National Institutes of Health (NIH) data reveal that nearly 1 in 3 adults in the U.S. have high blood pressure, a condition that many young adults don’t realize they have until it’s too late.
6. Excessive Alcohol Consumption
Drinking large amounts of alcohol can lead to heart disease in both the short and long term. In the short term, alcohol can cause irregular heart rhythms (arrhythmias) and high blood pressure. Over time, heavy drinking can lead to cardiomyopathy (weakened heart muscle) and increase the risk of a heart attack. The CDC reports that binge drinking (consuming five or more drinks in a sitting) is common among young adults and significantly increases heart disease risk.
Read More: Stroke vs. Heart Attack: What’s the Difference?
The Heart Attack Symptoms You Shouldn’t Ignore
You might believe that heart attacks only present as excruciating chest pain, but the signs of a heart attack in young people can be far subtler. In fact, some heart attacks in younger individuals present with vague or atypical symptoms that can be mistaken for something less serious, like indigestion or anxiety. Symptoms like nausea, shortness of breath, and unusual fatigue are often overlooked or brushed aside.
Women often experience different heart attack symptoms than men, which can make recognition and diagnosis more challenging. While chest pain or discomfort remains the most common symptom in both sexes, women are significantly more likely to have additional or atypical symptoms that may not immediately suggest a heart attack. Women are much more likely to have atypical heart attack symptoms such as indigestion, shortness of breath, and back pain, sometimes even in the absence of obvious chest discomfort.
Young people must recognize the early signs of heart distress, particularly if they have risk factors like family history or high cholesterol. Don’t ignore persistent chest discomfort, pain in the jaw or left arm, or unexplained sweating.
Preventive Measures: How to Protect Your Heart
The good news is that many of the factors contributing to heart attacks in young people are preventable. With healthy lifestyle changes, you can significantly reduce your risk of heart attacks, even at a young age. Here are some actionable steps to protect your heart:
1. Adopt a Heart-Healthy Diet
To protect your heart, it’s essential to focus on whole, nutrient-dense foods. It means you need to consume plenty of fruits and vegetables, whole grains, lean proteins (such as fish and chicken), and healthy fats (like those found in avocados and olive oil). When you reduce the intake of processed foods, trans fats, and sugary foods, you can also lower your cholesterol and blood pressure, which can reduce the risk of heart disease. For instance, you can adopt the DASH diet, which emphasizes fruits, vegetables, whole grains, low-fat dairy, lean proteins, and limits salt, saturated fat, and added sugars to lower blood pressure and cholesterol.
2. Exercise Regularly
Regular physical activity is one of the most effective ways to protect your heart. Experts recommend at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous exercise each week. This helps control weight, reduce blood pressure, and improve cardiovascular health. Even activities like walking, biking, or swimming can have profound heart-health benefits.
In fact, walking just 30 minutes a day is a great starting point for improving heart health. It’s an accessible and effective way for people of all ages and fitness levels to protect their heart and overall health.
3. Quit Smoking
Quitting smoking is one of the best things you can do for your heart. Smoking damages blood vessels and increases the likelihood of clot formation. Fortunately, there are many resources available to help you quit, including counseling, nicotine replacement therapies, and support groups.
4. Manage Stress and Mental Health
Finding healthy ways to cope with stress is essential. Regular relaxation techniques like meditation, yoga, deep breathing exercises, or mindfulness can help reduce the negative effects of stress on your heart. If you are dealing with mental health issues like anxiety or depression, seeking professional support from a therapist or counselor is vital. Mental well-being is deeply connected to physical health, so taking care of your mind is just as important as taking care of your body.
5. Regular Health Check-Ups
Make sure to monitor your health regularly, even if you are feeling fine. Regular checkups with a healthcare provider can help catch conditions like high blood pressure, high cholesterol, or diabetes early on. Catching these issues early can help you take preventive action before they lead to serious health problems like heart disease.
For instance, a basic lipid panel is a blood test that measures key fats in your blood, such as total cholesterol, LDL (“bad”) cholesterol, HDL (“good”) cholesterol, and triglycerides to help predict your risk for heart disease and stroke. Blood pressure (BP) monitoring is another essential tool for heart health. Regular BP checks help detect high blood pressure, a major risk factor for heart attack and stroke.
Protect Your Heart Now for a Healthier Future!
Heart attacks in young people are no longer rare occurrences; they are becoming an alarming trend. Studies show that heart problems in young adults have been rising over the years. This is a clear reminder to take better care of your health. By making positive lifestyle changes and staying informed about your health, you can significantly reduce your risk of heart disease. It’s never too early to start protecting your heart, and the sooner you act, the healthier you’ll be for years to come.
Despite the preventive measures, young people are not immune to the growing epidemic. In such life-threatening moments, with CPR, you can potentially save a young person’s life. Immediate chest compressions and early intervention can stabilize them until professional help arrives. Take a CPR course today and be prepared to act during an emergency!
Frequently Asked Questions (FAQs)
- What is causing heart attacks in young people?
In young people, heart attacks are often caused by undiagnosed conditions like genetic heart disorders, high blood pressure, or high cholesterol. Lifestyle factors such as poor diet, stress, smoking, and lack of exercise also contribute. Even severe stress or drug use can trigger a heart attack in younger individuals, highlighting the importance of maintaining heart health from an early age.
- Why are seemingly fit young people getting heart attacks?
Even if you’re physically fit, you might still be at risk of a heart attack. Conditions like genetic heart disease, underlying inflammation, or undiagnosed heart conditions can affect even the healthiest individuals. Overtraining, high stress, or poor recovery habits can strain your heart, making it vulnerable. It’s essential to balance fitness with proper health monitoring and lifestyle choices.
- Why are there so many heart attacks after COVID?
After COVID, some people are experiencing heart issues due to lingering inflammation or damage caused by the virus. COVID can increase clotting, raise heart strain, and cause long-term effects on the cardiovascular system. If you have had COVID, monitor your heart health and consult a doctor if you experience symptoms like chest pain or shortness of breath.
- Why are heart attack cases increasing?
The rise in heart attack cases can be linked to factors like poor diet, lack of exercise, stress, and increasing rates of obesity. Additionally, the global pandemic has worsened mental health, leading to higher stress and unhealthy habits. As people are living longer, conditions like diabetes and high blood pressure are becoming more common, contributing to the increase in heart attacks.
