Why Are More Young Adults Having Heart Attacks?

Cardiovascular disease has long been associated with unhealthy lifestyle habits as well as chronic conditions like high blood pressure and diabetes. Among younger people, obesity and diabetes are reaching epidemic levels, and several lifestyle habits contribute to the increase in heart disease and heart attacks, including:

Sedentary behavior: Younger adults are more likely to have been less active as children and adolescents than older adults. More television and movie options, video games and handheld devices can translate to more “screen time” and less time doing even minimal physical activity.

High intake of processed foods: Packaged foods, fast foods and instant meals are quicker and easier than preparing meals with whole foods, but their high amounts of salt, sugar, fat and additives can contribute to heart disease. Ultra-processed foods such as sodas, frozen pizza and lunch meat typically contain five or more additives including preservatives, emulsifiers and artificial flavors.

Substance use: Smoking, vaping, recreational drugs and heavy alcohol use all elevate heart attack risk in younger people.

Mental health stress: Chronic stress, anxiety and depression, all more prevalent in younger generations, are linked to cardiovascular risk. Not only do they directly raise the risk, unhealthy coping behaviors (including substance abuse) can also contribute. 

Post-COVID cardiovascular effects: Some research suggests that COVID-19 infection can have lingering effects on the heart, increasing the risk of heart attack and other cardiac conditions for months or even years after infection.

“Many young adults underestimate their risk for heart attack because of their age,” says Todd Hitchcock, MD, a cardiologist at Scripps Clinic Anderson Medical Pavilion in La Jolla. “Plus, heart attack symptoms in younger patients may be missed or dismissed by both patients and providers.”

The classic heart attack symptoms are still the most common and can happen at any age. These include:

• Chest pain, pressure, squeezing or heaviness that lasts more than a few minutes or comes and goes

• Pain that spreads to the left or right arm, neck, jaw, upper back or between the shoulder blades

• Shortness of breath with or without chest pain

• Cold sweat

• Nausea or vomiting

• Lightheadedness or dizziness

Younger people may not recognize these symptoms as cardiac-related, instead attributing them to anxiety, stress, muscle pain or other causes. While they don’t always indicate a heart attack, they shouldn’t be ignored.

“If your chest discomfort is new or worsening and you don’t know what’s causing it, it’s an emergency, even in your 30s or 40s,” says Dr. Hitchcock. “You need medical attention regardless of age.”

Many people who have had a heart attack, especially women, say they never had any chest pain. Younger adults may be more likely to have less common heart attack symptoms, such as:

• Unusual fatigue, including sudden or persistent tiredness that may start days before the heart attack

• Indigestion-like symptoms, such as GI burning, pressure or nausea

• Shortness of breath with minimal activity

• Anxiety or a feeling of “something being wrong” without an explanation

• Sleep disturbances in the days leading up to an event

Again, many of these symptoms can be caused by other, less-serious conditions. However, writing them off or waiting to see if they go away can lead to dangerous delays in treatment and more severe heart damage. If symptoms are new, unexplained or alarming, call 911 or go to the emergency room right away.

“Some people are concerned they will be overreacting if it’s nothing serious, but we would rather you come in just to be sure,” says Dr. Hitchcock. “It’s always better to err on the side of caution.”