Younger women face overlooked heart attack risks, Mayo Clinic warns

Researchers in the US warn that many women under 65 have heart attacks linked to artery tears or stressors, not plaque build-up, underscoring the need for better diagnosis

Heart attacks are on the rise among younger people, and clogged arteries are not always to blame, especially in women. A new study by Mayo Clinic (a global, non-profit academic medical centre in the US) has uncovered hidden triggers, from artery tears to stress-related factors, which are often missed in routine diagnosis and can prove deadly if overlooked.

 

The research, published in the Journal of the American College of Cardiology, extensively reviewed data from over 15 years from the Rochester Epidemiology Project. It reveals why traditional approaches to diagnosing heart disease may not be enough for younger patients.

 

What the study revealed 

For decades, blocked arteries caused by plaque build-up have been considered the leading culprit behind heart attacks. But the research team found that while this remains true for many men, women tell a different story.

 

 

• 68 per cent of the heart attacks reviewed in the study were caused by typical plaque build-up associated with traditional heart disease. However, non-traditional causes made up the majority of cases in women.
• Spontaneous coronary artery dissection (SCAD) was found to be nearly six times more common in women than in men.
• Heart attacks triggered by stressors such as anaemia or infection are the second-most common cause overall, and the deadliest, with a five-year mortality rate of 33 per cent.
• Truly unexplained heart attacks were rare, accounting for fewer than 3 per cent of cases after expert review.

 

The study confirms that atherosclerosis, or plaque build-up, remains the most common cause of heart attacks in both sexes. While it accounted for 75 per cent of cases in men under 65, it explained only 47 per cent in women, pointing to alternative causes such as spontaneous coronary artery dissection (SCAD). SCAD occurs when a tear forms in the coronary artery wall, restricting blood flow.

 

“This research shines a spotlight on heart attack causes that have historically been under-recognized, particularly in women,” said Dr Claire Raphael, an interventional cardiologist at Mayo Clinic and senior author of the study. “When the root cause of a heart attack is misunderstood, it can lead to treatments that are less effective or even harmful,” she said. 

 

A wake-up call for women’s hearts 

The findings of the study - Causes of Myocardial Infarction in Younger Patients: Troponin-Elevation in Persons ≤65 Years Old in Olmsted County, are particularly urgent for women’s health. Despite public health campaigns raising awareness about heart disease, the stereotype of a heart attack as a “man’s problem” persists. Experts say the Mayo Clinic study underlines the need for women under 65 to be taken seriously when presenting with chest pain or other warning signs.

 

“Our research highlights the larger need to rethink how we approach heart attacks in this patient population, and for younger adult women, in particular. Clinicians must sharpen their awareness of conditions like SCAD, embolism and stress-related triggers, and patients should advocate for answers when something doesn’t feel right,” said Dr Rajiv Gulati, senior author of the study and chair of the division of interventional cardiology and ischemic heart disease at Mayo Clinic. 

 

The road ahead 

Researchers stress that more work is needed to understand why conditions like SCAD disproportionately affect younger women. Hormonal factors, pregnancy-related changes and autoimmune conditions are among the theories being investigated.

 

For the public, especially women, the message is clear- don’t ignore chest pain, shortness of breath or unusual fatigue, and don’t hesitate to ask questions if something feels amiss. “Understanding why a heart attack happened is just as important as treating it. It can mean the difference between recovery and recurrence,” said Dr Raphael.

 

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This report is for informational purposes only and is not a substitute for professional medical advice.