by Giancarlo Marenzi
Acute myocardial infarction predominantly affects adults or the elderly, rarely occurring in young people. What are the factors that can lead to necrosis of a part of the heart muscle
I am 22 years old and have been suffering from chest pains that come and go for months. I turned to several doctors to understand the origin of these pains. My blood pressure and heart rate were normal, but I’m afraid it could be a heart attack. I described the symptoms to various cardiologists, but they told me that at 22 you can’t have a heart attack. What do you think about it?
Answered by Giancarlo Marenzi, director of cardiac intensive care and translational diagnostics and therapeutics program, Monzino Cardiology Center, Milan (GO TO THE FORUM)
It is practically certain that the symptoms you are experiencing, considering your young age and the characteristics of the chest pains which last for months and are intermittent, do not represent signs of a heart attack. I presume that whoever reassured her still performed at least an electrocardiogram and that this was normal. However, it is right to underline the fact that, although acute myocardial infarction mainly affects adults and elderly people, it can rarely also affect very young people. The causes of heart attack in young individuals usually differ from those in older individuals.
Congenital diseases or genetic factors
The causes of heart attack in young people can be: 1) spontaneous coronary dissection, which occurs when there is a spontaneous separation of the various layers of the wall of the coronary artery, which is the blood vessel that supplies blood to the heart; 2) some congenital diseases of the coronary arteries characterized by an anomalous course; 3) some genetic factors (e.g. severe familial hypercholesterolemia); 4) inflammatory diseases affecting the vessels (e.g. vasculitis); 5) the use of drugs, especially cocaine and amphetamines. In the absence of these conditions, which I imagine were considered and excluded by the doctors who evaluated his symptoms, myocardial infarction practically never occurs in a 22-year-old person.
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December 8, 2023 (modified December 8, 2023 | 09:08)
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