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Heart attacks don’t always look the same — and a new study from Mayo Clinic highlights the key differences between how they affect men and women.
The most common cause of heart attacks overall is clogged arteries (atherosclerosis), but in people under 65 — particularly women — there are often other factors at play.
Atherosclerosis is responsible for 75% of men’s heart attacks, but only 47% of women’s cardiac events, data shows.
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In the study, which was published in the Journal of the American College of Cardiology, researchers analyzed more than 15 years of data on 1,474 heart attacks.
They found that more than half of heart attacks in women under age 65 were caused by “nontraditional factors.”
Those included embolisms and spontaneous coronary artery dissection (SCAD), among other factors.
The researchers also found that the underlying causes of women’s heart attacks were often overlooked or misdiagnosed.
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SCAD — a rare but serious condition that occurs when a tear develops within the coronary artery — is nearly six times more common in women compared to men.
It is often misdiagnosed as a typical heart attack caused by plaque buildup, which could result in stents being placed unnecessarily, the researchers noted.
People who experienced heart attacks caused by stressors like anemia or infection had higher five-year mortality rates, the study found.
“Recognizing and correctly diagnosing these nontraditional heart attacks allows for more appropriate care and better long-term outcomes,” the release stated.
Less than 3% of heart attacks were “truly unexplained.”
“When the root cause of a heart attack is misunderstood, it can lead to treatments that are less effective — or even harmful.”
“This research shines a spotlight on heart attack causes that have historically been under-recognized, particularly in women,” said Claire Raphael, M.B.B.S., Ph.D., an interventional cardiologist at Mayo Clinic and first author of the study, in a press release.
“When the root cause of a heart attack is misunderstood, it can lead to treatments that are less effective — or even harmful.”
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Senior author Rajiv Gulati, M.D., Ph.D., chair of the Division of Interventional Cardiology and Ischemic Heart Disease at Mayo Clinic, said the research highlights the need to rethink how heart attacks are approached, particularly in younger women.
“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,” he said in the release.
“Understanding why a heart attack happened is just as important as treating it,” Raphael added. “It can mean the difference between recovery and recurrence.”
Dr. Bradley Serwer, a Maryland-based cardiologist and chief medical officer at VitalSolution, an Ingenovis Health company that offers cardiovascular and anesthesiology services to hospitals nationwide, was not involved in the study but commented on the findings.
“It is crucial to recognize that not all heart attacks are identical or caused by the same events,” he said in a statement provided to Fox News Digital. “Being young, healthy and female does not guarantee immunity from heart attack.”
The cardiologist emphasized the importance of listening to your body and realizing that no one is immune from a heart attack.
“It is important to maintain a healthy lifestyle, exercise, avoid smoking and know the status of any chronic medical conditions such as diabetes, high blood pressure or high cholesterol,” he advised.
“The most effective advocate is a well-informed patient,” Serwer added. “It is crucial to be aware of your medical history, medications and specific cardiac risk factors.”
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In the event of new onset chest pain, shortness of breath or severe exertional fatigue, the doctor said it’s essential to seek immediate medical attention.
“Do not ignore the symptoms because you may be considered low risk for a heart attack,” he said.
“Being young, healthy and female does not guarantee immunity from heart attack.”
The study does have some limitations, Serwer noted, including a lack of ethnic diversity.
“The research also did not account for severity of the underlying medical conditions,” he said.
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Overall, this study serves as a reminder that there are many different causes of heart attacks, Serwer said.
“We need to keep an open mind when evaluating a younger patient with potential cardiac symptoms. There is not a ‘one-size-fits-all’ approach to treating heart attacks in the young.”
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