New Insights into the Hidden Causes of Heart Attacks in Younger Adults, Particularly Women

A recent study conducted by Mayo Clinic uncovers surprising factors behind heart attacks in individuals under 65, with a special focus on women. Traditionally, heart attacks have been attributed mainly to clogged arteries caused by atherosclerosis. However, this comprehensive research, analyzing over 15 years of data from the Rochester Epidemiology Project, reveals that more than half of heart attacks in women under 65 are due to nontraditional causes such as spontaneous coronary artery dissection (SCAD), embolism, or other conditions unrelated to plaque buildup.

The study shows that while atherosclerosis remains the leading cause in both men and women, it accounts for only 47% of cases in women, compared to 75% in men. Notably, SCAD, which predominantly affects healthy, young women, was often misdiagnosed as a typical plaque-related heart attack, leading to inappropriate treatment. The same applies to heart attacks triggered by stressors like anemia or infections, which proved to be more deadly, with a five-year mortality rate of 33%.

This research emphasizes the importance of recognizing these nontraditional causes for accurate diagnosis and treatment. Misdiagnosis can result in unnecessary procedures, such as stent placement in cases of SCAD, which may increase complication risks. Understanding the true underlying cause of a heart attack can significantly improve patient outcomes.

Key insights from the study include:

• Out of 1,474 heart attacks, 68% were caused by traditional plaque buildup, but nontraditional causes dominated in women.
• SCAD was nearly six times more common in women than in men.
• Heart attacks due to stress-related factors were the second most common and the most lethal, with a high mortality rate over five years.
• Truly unexplained heart attacks were very rare, constituting less than 3% after expert review.

Expert commentary highlights that this shift in understanding could reshape how clinicians diagnose and treat heart attacks, especially in younger adults. Dr. Claire Raphael from Mayo Clinic notes that identifying the root cause is crucial for effective management and recovery. Dr. Rajiv Gulati adds that increased awareness of conditions like SCAD and embolism can lead to better life-saving strategies.

This groundbreaking study advocates for improved awareness in both medical professionals and patients, urging clinicians to consider these atypical causes when evaluating young women and men with heart attack symptoms. Recognizing these conditions early can prevent unnecessary procedures and reduce mortality rates, ultimately saving lives.

Source: https://medicalxpress.com/news/2025-09-reveals-hidden-heart-younger-adults.html