Heart disease is often seen as a condition of older men, but a new Mayo Clinic study has delivered a wake-up call: younger women are increasingly experiencing heart attacks, and the causes are far more complex than the traditional “blocked arteries” narrative.
Published this week, the study reveals that more than half of heart attacks in women under 65 are linked to nontraditional causes, with many going undiagnosed or mismanaged due to outdated clinical assumptions.
Not Just Blocked Arteries: What’s Really Happening
Traditionally, heart attacks are caused by atherosclerosis – a buildup of plaque in arteries that reduces blood flow. But researchers found that younger women often suffer from heart attacks triggered by very different mechanisms:
- Spontaneous Coronary Artery Dissection (SCAD):
A sudden tear in the wall of a coronary artery, restricting blood supply to the heart. SCAD was found to be six times more common in women than men, and is now considered one of the leading causes of heart attacks in women under 50. - Stress-Induced Heart Attacks:
Acute stressors such as severe infections, anemia, or extreme emotional stress can trigger attacks without the presence of artery blockage. Alarmingly, these stress-related heart attacks carried the highest five-year mortality rate (33%), according to the study. - Other Rare Causes:
Blood clots (embolisms), coronary spasms, and microvascular dysfunction also played significant roles in younger women’s heart events.
Why Women Are Being Misdiagnosed
The Mayo Clinic report highlights a critical problem: delays in diagnosis.
- Different Symptoms: Women often report atypical signs — fatigue, shortness of breath, jaw pain, dizziness – rather than the “classic” crushing chest pain.
- Fewer Traditional Risk Factors: Many young women don’t have high cholesterol, diabetes, or smoking histories, leading doctors to overlook heart disease.
- Standard Tests May Miss It: Traditional angiograms can fail to detect SCAD or small vessel disease, resulting in misdiagnosis and inappropriate treatments.
This gap in recognition means many women receive delayed care or interventions that could worsen their condition – for example, inserting stents in SCAD cases, which may actually cause further damage.
The Human Toll
Heart disease remains the leading cause of death among women globally, and the rise of nontraditional heart attacks in younger women poses a new challenge. Experts warn that overlooking these cases risks preventable deaths, as patients often don’t receive the right diagnosis or treatment in time.
The emotional impact is also profound: many women report feelings of dismissal when their symptoms are minimized or attributed to anxiety or stress rather than heart disease.
What Needs to Change
The Mayo Clinic study calls for major shifts in both awareness and medical practice:
- Updated Diagnostic Protocols
Doctors should include SCAD, embolisms, and stress-induced attacks in standard evaluation for women presenting with chest pain or cardiovascular symptoms. Advanced imaging techniques may be necessary. - Tailored Treatments
Treatments effective for plaque-based heart attacks aren’t always appropriate for SCAD or stress-related cases. Clinical guidelines need adjustment to reflect these differences. - Increased Awareness Among Women
Women under 65 — even without risk factors — should recognise potential warning signs: chest pressure, shortness of breath, extreme fatigue, back or jaw pain, or fainting episodes. - Long-Term Research and Education
More studies are needed to understand why women are disproportionately affected, and medical education must evolve to train physicians on gender-specific cardiac risks.
The Mayo Clinic’s findings are clear: young women are not immune to heart attacks, and their risks often look very different from men’s. By rethinking diagnosis, treatment, and awareness, healthcare systems can save lives and prevent a silent crisis in women’s heart health.
