A groundbreaking study from the Mayo Clinic suggests that traditional explanations for heart attacks may be obscuring other critical causes, particularly in younger adults. While most heart attacks are blamed on atherothrombosis—where clogged arteries lead to dangerous blood clots—new research indicates that this is not always the full story, a finding with significant implications for treatment and prevention.
The Gender Divide in Heart Attack Causes
Researchers analyzed 1,474 heart attack cases in patients aged 65 or younger in Olmsted County, Minnesota, between 2003 and 2018. The analysis, which meticulously reviewed medical records and imaging, pinpointed a primary cause for each incident.
The findings showed a clear difference between men and women:
- Men: Atherothrombosis accounted for 75 percent of heart attacks, aligning with traditional understanding.
- Women: Atherothrombosis was the cause for only 47 percent—less than half—meaning a majority were due to other factors.
This research highlights heart attack causes that haven't been adequately recognized, especially in women, according to cardiologist Claire Raphael.
Beyond Clogged Arteries
The study highlighted several alternative causes that significantly contributed to heart attacks, including:
- Spontaneous Coronary Artery Dissections (SCADs): Tears in the artery walls that can collect blood and block flow.
- Embolism: Blood clots that travel to the heart from other parts of the body.
- Stressors: Other physical factors acting on the body, such as anemia.
Crucially, the team found that many SCAD-related heart attacks were initially misattributed to atherothrombosis, especially in women. SCAD was found to be the cause nearly six times more frequently in women than in men.
Misdiagnosis can lead to ineffective or even harmful treatment, according to Dr. Raphael. "When the root cause of a heart attack is misunderstood, it can lead to treatments that are less effective—or even harmful."
Call for Greater Awareness
The researchers are urging clinicians to "sharpen their awareness" of conditions like SCAD, embolism, and stress-related triggers. Cardiologist Rajiv Gulati emphasizes the need to rethink how heart attacks are approached in this population, "and for younger adult women, in particular."
While the study didn't explore why there is such a difference between men and women, future research will look into whether risk factors affect women differently or if women are less likely to seek timely medical attention.
Despite the complexities, there is good news: advancements in heart imaging are improving the ability to spot, diagnose, and prevent recurrent heart attacks. The study authors stress that increased awareness among both health professionals and the public of these alternative causes is essential, with Dr. Raphael concluding, "Understanding why a heart attack happened is just as important as treating it. It can mean the difference between recovery and recurrence."
Disclaimer: This content is published only for health awareness and informational purposes. It's not a substitute for your professional medical advice. You must consult a doctor/healthcare professional regarding your specific health concerns.
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