Myocardial infarction in persons under the age of 45 years accounts for 6% to 10% of all
Frequency of MI in younger subjects
- The Framingham Heart Study : Incidence of an MI over a 10 year follow-up was 12.9/1000 in men 30 to 34 years old and 5.2/1000 in women 35 to 44 years old
- In other studies, 4 to 10 percent of patients with MI were ≤40 or 45 years of age.
- In two series of patients with CHD at ≤40 years of age, women comprised 5.6 and 11.4 percent of patients
Most young patients with MI, up to 82% in one study, have typical atherosclerotic coronary artery disease. This manifests more often as a single-vessel disease in younger patients than in older patients.
Coronary artery embolism
-Patent foramen ovale
-Systemic lupus erythematosis
-Procoagulant /anticoagulant genetic
Smoking produces endothelial dysfunction and can precipitate coronary spasm.
Cigarette smoking appears to be the most common risk factor in young MI patients.
- Homozygous familial hypercholesterolemia appears to have the most consistent relation with premature atherosclerosis and MI.
- Increased TG levels and decreased HDL cholesterol levels have also been reported in MI patients under age 45 years.
- Cocaine blocks the presynaptic reuptake of norepinephrine and dopamine, producing an excess of these neurotransmitters at the site of the postsynaptic receptor.
- Acutely, cocaine increases heart rate and blood pressure and decreases coronary blood flow through vasospasm, thereby leading to increased myocardial oxygen demand and reduced oxygen supply.
Coronary artery Anomalies
- Congenital coronary artery anomalies account for approximately 4% of MIs in young patients.
- Several such anomalies, including a deep intramyocardial course, an origin from the wrong
coronary sinus, or ostial obstruction, have been associated with MI and sudden death in young
- Spontaneous coronary artery dissection
- Coronary arteritis in vasculitic disorders such as SLE
- Coronary aneurysms in Kawasaki’s disease
- Blunt chest trauma causing coronary thrombosis or dissection
- Mediastinal irradiation therapy for Hodgkin’s disease
- Valvular abnormalities
- Embolization from infective endocarditis
How to prevent ?
-Healthy lifestyle is the key.
-Avoid smoking cigarettes, tobacco use, drugs (cocaine, methamphetamines, etc)
-Frequent check ups in those having strong family history of heart disease
-Do not neglect symptoms of heart attack, in an emergency visit best cardiac hospital in Bangalore immediately