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Heart Attack in Young Patients

Heart Attack in Young

Myocardial infarction in persons under the age of 45 years accounts for 6% to 10% of all

myocardial infarction.

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.



-Single-vessel disease

-Multivessel disease

Coronary artery embolism

-Patent foramen ovale


Hypercoagulable states

-Oral contraceptives

-Systemic lupus erythematosis

-Procoagulant /anticoagulant genetic


Cigarette smoking

Smoking produces endothelial dysfunction and can precipitate coronary spasm.

Cigarette smoking appears to be the most common risk factor in young MI patients.

Physical inactivity


Lipid Abnormalities

  • 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)

-Regular exercises

-Weight reduction

-Healthy diet

-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

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