Half of heart attacks in younger women due to non-artery blockage causes, Mayo Clinic study reveals

UAE—A recent study conducted by the Mayo Clinic reveals that many heart attacks in people under 65, particularly women, stem from causes other than clogged arteries.

This finding challenges the long-held belief that artery blockages are the primary cause of heart attacks in younger populations.

Published in the Journal of the American College of Cardiology, the study analyzed more than 15 years of data from the Rochester Epidemiology Project.

It represents the most detailed population review of heart attack causes in individuals aged 65 and younger.

The study found that over half of heart attacks in women under 65 were linked to nontraditional causes such as spontaneous coronary artery dissection (SCAD), embolism, and other conditions unrelated to artery plaque.

Although heart attacks occurred less frequently in women than men, when women did experience heart attacks, the underlying causes were often misdiagnosed.

SCAD, a condition that typically affects younger, otherwise healthy women, was frequently overlooked or mistaken for a heart attack caused by typical artery plaque buildup.

While atherosclerosis remained the most common cause of heart attacks in both sexes, it accounted for only 47% of heart attacks in women, compared to 75% in men.

Additionally, the five-year mortality rates were highest among patients whose heart attacks were triggered by stress-related factors such as anemia or infection.

These patients showed lower levels of heart injury, yet faced greater risks over time.

Claire Raphael, M.B.B.S., Ph.D., an interventional cardiologist at Mayo Clinic and lead author of the study, emphasized the importance of this research.

She explained that misunderstanding the root cause of a heart attack can lead to less effective or even harmful treatments.

For example, misdiagnosing SCAD often results in unnecessary stent placement, which can increase complications.

Proper recognition and diagnosis of these nontraditional heart attacks enable more tailored treatments and improved long-term results.

Out of 1,474 cases reviewed in the study, 68% were caused by typical artery plaque buildup, but nontraditional causes dominated heart attacks in women.

The research also found that SCAD was nearly six times more common in women than men.

Moreover, heart attacks triggered by stressors like anemia or infection were the second most common cause and had the highest five-year mortality rate at 33%.

Heart attacks that were truly unexplained after expert evaluation made up fewer than 3% of all cases reviewed.

Rajiv Gulati, M.D., Ph.D., chair of the Division of Interventional Cardiology and Ischemic Heart Disease at Mayo Clinic and senior author of the study, stressed the need for increased awareness among clinicians.

He noted that understanding conditions like SCAD, embolism, and stress-related triggers is crucial, especially for younger women, and encouraged patients to seek clear answers when symptoms arise.

Dr. Raphael added that knowing why a heart attack occurred is as important as treating it, as it significantly influences recovery and the risk of recurrence.