Heart attacks in young women: study data and key figures
The study, published in the Journal of the American College of Cardiology and based on 15 years of records from the Rochester Epidemiology Project, analyzed 1,474 heart attacks in people up to 65 years of age, according to the report itself. The results refute a widely held assumption: atherosclerosis does not explain the majority of attacks in young women.
The authors warn that up to half of heart attacks in women were attributed to causes other than plaque blockage, while in men, atherosclerosis remains the predominant cause. This difference requires a different approach when a young patient presents with coronary symptoms.
Among the alternative etiologies, spontaneous coronary artery dissection stands out, a lesion that primarily affects women without traditional risk factors and requires a specific diagnostic and therapeutic approach. The study shows that CAED occurred much more frequently in women than in men.
Heart attacks in young women: differential diagnosis and recommended tests
Another relevant category is heart attacks induced by acute stress factors—such as anemia or infections—which, although not the most common, did have the highest five-year mortality rate. Researchers report that these stress-associated episodes had a considerably high five-year mortality rate.
The group of specialists emphasizes that mistaking a CABG or coronary embolism for a plaque-induced infarction can lead to unnecessary procedures—for example, implanting a stent—and, in some cases, worsen the prognosis. Therefore, they recommend more detailed diagnostic protocols and expert review of each case .
Heart attacks in young women: diagnosis and main causes
The data indicate that only a minority of attacks remained truly unexplained after evaluation: less than 3% of cases could not be linked to a specific cause after multidisciplinary review. This reinforces the idea that, in general, it is possible to identify the mechanism and adjust therapy.
For doctors and patients , the conclusion is clear: in young adults, and especially in women, the diagnostic approach needs to be broadened. The Mayo Clinic report proposes that etiological investigation be a priority to improve recovery and reduce the risk of relapse.
