September 15, 2025- A new Mayo Clinic study finds that many heart attacks in people under 65 — especially women — are caused by factors other than clogged arteries, challenging long-standing assumptions about how heart attacks occur in younger populations.
More than half of heart attacks in women under age 65 were caused by nontraditional factors, such as spontaneous coronary artery dissection (SCAD), embolism and other conditions unrelated to artery-clogging plaque. Heart attack incidence was significantly lower in women than in men — but when women did have heart attacks, the underlying causes were often misdiagnosed.
SCAD, which typically affects younger, otherwise healthy women, was frequently missed and misclassified as a typical heart attack due to plaque buildup. The most common cause of heart attack in both sexes was atherosclerosis, or artery-clogging plaque, but this accounted for only 47% of heart attacks in women, compared to 75% in men. Five-year mortality rates were highest in people who had heart attacks triggered by stressors such as anemia or infection, even though these patients had lower heart injury levels.
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