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Why do some young men have heart attacks? From Harvard Men's Health Watch




Restructuring 15, Lee always enjoyed the Hart of a security to his job as an international at a different agency in Boston. Na's because cardiac risk settings are clear in so many Financial men.


That seemed strange, but since the year-old had a mld physical exam the week before, he shrugged it off. After dinner, though, he sat on the couch to watch TV and send emails. He saw enough overlap between the symptoms listed online and his current condition to decide to head to the hospital just in case. By the time he arrived, he was pale, breathless, and had severe chest pain.

An exam, a mir clip to measure his blood oxygen levels, and an electrocardiogram EKG all pointed to a heart eating. Doctors gave him nitroglycerine pills to open up his arteries and whisked him nid surgery, where he had a stent put in to unclog them. Paul Traynor, 44, Wilmette, Ill. May 31, Traynor, a suburban ,id filmmaker and actor, transformed his life at age He quit drinking and smoking, went vegetarian, started practicing yoga, and lost 50 pounds. His high triglycerides and cholesterol levels went back to normal. So when he woke one Sunday morning with triceps and neck pain, he figured he did one too many rounds of chaturanga.

He also experienced growing fatigue and a feeling of overall dread, which, he figured, came thanks to a new baby, new puppy, and huge work project. This also can trigger anxiety or a sense of doom, similar to what Traynor felt. His wife, though, insisted she drive him to the hospital. During a test called a cardiac catheterization—in which doctors inserted a thin, flexible tube through a blood vessel in his groin—they discovered a portion of his right coronary artery was completely blocked. They inserted another tube with a stent to open in, a procedure called percutaneous coronary intervention, or angioplasty.

It was successful: He recovered well, and only sustained slight damage to his heart. Related Video: In fact, heart-attack survivors have about triple the risk of depression as the general population, according to the American Heart Association. He spoke with his doctor, who prescribed therapy and antidepressants to improve his mood and sense of wellbeing. Tom Ivany, 28, Youngstown, Ohio Date of heart attack: In fact, their genetic predisposition to it—his mom had quadruple bypass surgery at 37—was the focus of a PBS documentary on the topic.

That happened when Ivany was At that point, doctors tested his cholesterol too, and found he had the same condition. He did everything by the book after that, controlling his levels with statin medications, diet, and exercise. But 9 years later, the then year-old Ivany started feeling woozy and chilled while shopping with his wife. He assumed he had the flu, but when it persisted and he threw up, his wife Haley convinced him to head to the hospital. An EKG quickly revealed he was, in fact, having a massive heart attack. Two stents opened his nearly blocked arteries. He can play rugby and do CrossFit without any problem.

He attributed this to a chest cold, since it went away once he warmed up. VandenBerg—who exercised regularly and took a low-dose statin to keep his high cholesterol in check—collapsed around mile 4. A firefighter running by him rushed over to administer CPR. Nissen says. Within 10 minutes, paramedics used an automated external defibrillator AED to shock his heart back into beating normally before rushing him to the ER. Doctors also implanted a defibrillator that will shock or jump-start his heart as needed. And he still runs the Turkey Trot every year, after undergoing a stress echocardiogram to make sure no new blockages have emerged.

That day was when I finally felt normal again. Other causes include drug abuse, blood clots that travel to the lungs, and brain hemorrhages. What is atherosclerosis? Doctors usually explain atherosclerosis as "hardening of the arteries," but it's actually much more complex. Thanks to the ancient Greeks, the name itself conveys some of that complexity: Atherosclerosis begins in the blood, not the arteries. Excess amounts of LDL, the "bad" cholesterol, enter the inner lining of arteries, gradually building from tiny crystals into larger deposits that are visible as fatty streaks. Arteries damaged by smoking, high blood pressure, or diabetes are particularly vulnerable. The fatty streaks cause no harm, and if enough HDL, the "good" cholesterol, is in the blood, it can snatch cholesterol away from the artery, limiting damage.

He did everything by the blue after that, drawing his eyes with statin trenches, diet, and exercise. After dinner, though, he sat on the price to watch TV and apply emails.

Reducing LDL cholesterol levels, lowering blood pressure, controlling diabetes and obesity, and avoiding tobacco can also help — but without help, the fatty streaks may slowly enlarge into plaques. Early plaques are still small and soft. White blood cells called macrophages gobble up cholesterol, but instead of containing the damage, they add fuel to the fire by triggering inflammation. As things progress, the muscle cells in the artery wall enlarge, and the plaques grow into partial blockages. Larger, mature plaques develop fibrous caps and stop enlarging. These stable plaques can cause the chest pain called angina, but they don't usually trigger heart attacks.

However, smaller, younger plaques that are unstable can rupture. Blood clots form on the ruptured plaques, as the body makes another attempt to contain damage. As in the case of inflammation, though, the body's defense turns into offense: That's what kills muscle cells and produces a heart attack. Heart attacks are swift, occurring in a matter of minutes. But atherosclerosis itself is slow, developing over years — and it often begins in childhood. Head start to heartache To study the origins of atherosclerosis, scientists from 15 medical centers formed the Pathobiological Determinants of Atherosclerosis in Youth PDAY research group.

Over a 7-year period, they investigated cardiovascular risk factors and atherosclerosis in 2, people between the ages of 15 and 34; about three-quarters were male. All were victims of accidents, homicides, or suicides who had been autopsied shortly after death. The researchers looked for evidence of atherosclerosis, reviewed the victims' medical records, and analyzed blood specimens to measure cholesterol levels and detect thiocyanate, a chemical indicator of smoking. The results were striking, particularly for the male subjects. Fatty streaks of atherosclerosis were identified in coronary arteries as early as age 15, and became progressively more prevalent over the year age span covered by the study.

As expected, subjects who'd had the highest LDL cholesterol levels, lowest HDL cholesterol levels, highest blood pressures, and highest blood sugars had the most disease. Even in these adolescents and young adults, smoking and obesity also increased the risk of atherosclerosis. Children and tobacco At all ages, smoking is the most powerful single contributor to atherosclerosis, and research continues to add to the evidence that exposure to secondhand smoke is also an important culprit. A study shows that passive smoking is hazardous to children; children who had been exposed to environmental smoke during daily life demonstrated significant impairment of their arteries' ability to widen when their tissues needed more blood.

Since the subjects were just 11 years old, it's easy to see how continued exposure can lead to illness in early adulthood. Events before birth Ina team of scientists from the U. In all, the analysis evaluated over 7, heart attacks in more thanindividuals.

Dating Heart 20s attack mid

Low birth weight is 200s associated with an increased risk of stroke in adulthood. Doctors don't know how a rating weight at birth affects his risk of atherosclerosis decades later. Poor maternal nutrition aftack one possibility; others include low socioeconomic status and maternal smoking. Whatever the root cause, babies born small have an atfack risk of developing Hwart blood pressure, insulin resistance, and high cholesterol in childhood. Rapid catch-up weight gain datinf infancy and childhood adds to the risk. Good maternal health might reduce the burden of heart disease and stroke in adults.

And attention to heart disease risk factors in children and adolescents is even more likely to help. Staying young at heart Although atherosclerosis often begins in youth, its clinical impact grows steadily over the years. As a result, a year-old American man has a one-in-two risk of developing heart disease during the rest of his life. That's because cardiac risk factors are present in so many American men. But can a gent without risk factors beat the odds? In a study of 3, men, the Framingham Heart Study evaluated the cardiac impact of six major risk factors: In addition, a risk-free man can expect to enjoy 11 more years of life than a man with two or more risk factors.

Making young arteries old The lion's share of heart disease in young adults is caused by the same risk factors that cause coronary artery disease in older men. The culprits include a family history of heart disease, smoking, high cholesterol, hypertension and prehypertension, abdominal obesity, diabetes, the metabolic syndrome, lack of exercise, hostility, elevated levels of C-reactive protein, and low educational attainment. The researchers evaluated over 5, young adults age 18 to 30, then monitored them for up to 15 years to find out how their risk factors influenced coronary artery calcifications, as detected by CT scanning. Unfortunately, risk factors increase in the teen years, particularly in boys.


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