Blocked arteries caused by cholesterol buildup is the primary cause of a heart attack. However, a striking new study has found some lesser-known and understood causes among younger people, especially women, including anemia and infection.
The large-scale study, published in the Journal of the American College of Cardiology, was conducted over a 15-year period and involved approximately 3,000 individuals aged 65 and under. Among the startling findings was that in over half of the cases of heart attacks in younger females, the causes are other than artery blockage.
How was the study conducted?
For this, the researchers tracked people aged 65 and under in Olmsted County, Minnesota, between 2003 and 2018, for elevated levels of the protein troponin, which is released when the heart muscle is damaged. The Mayo Clinic team, which conducted the study, found a whopping 4,116 troponin-positive events among 2,790 individuals. Each case was then reviewed by examining medical records, coronary angiograms, and heart imaging.
On #WorldHeartDay, let us come together to foster a heart-healthy community by adopting mindful lifestyle choices that safeguard our hearts today and for the years ahead. pic.twitter.com/jcXWIEp5HR
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The cases were then classified into six distinct categories based on the cause of muscle damage. The six categories were:
- Traditional artery blockage, or atherothrombosis
- Spontaneous coronary artery dissection (SCAD)
- Supply-demand mismatches
- Artery spasms
- Embolism
- Unexplained causes
Study findings
While women had fewer cases of heart attack than men, the underlying causes among them were often misdiagnosed. For example, as many as 75 per cent of heart attacks in younger males were caused by artery blockages, but the cause was found in only 47 per cent of females. In fact, SCAD was found to be common among women, accounting for 11 per cent of heart attack cases among them, compared to less than 1 per cent among men.
Here, notably, misdiagnosis is a key problem, as treating SCAD like a traditional heart attack can be damaging. However, patients with SCAD had no deaths during the period the study was conducted.
However, in cases where women had a heart attack because of artery buildup, they were as sick as men.
Notably, the highest death rates, with a five-year mortality rate of 33 per cent, were caused by secondary heart attacks, caused by cases of severe anemia or dangerously low blood pressure.
Unexplained cases were fewer, making up less than 3 per cent of cases.
Why is the study important?
The study is important to understand the difference in heart attacks among men and women, as it also determines the course of treatment. This is crucial because if, for example, a case of SCAD is treated traditionally with a stent, it can elevate the risk of further complications.
In general, the study is crucial in understanding the several lesser-known and misunderstood causes behind heart attacks which can help with better-informed treatment.
