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Dr. Anoop Agrawal, Thursday, October 19, 2023

The quick answer is ‘no’, but let us understand this a little further. Heart attack, in the true sense, happens when blood flow to the heart muscle is interrupted. Causes of Heart Attack can be grouped into three discrete scenarios, as explained below:

1. Blockages due to cholesterol deposit: This is the most common cause of heart attack, accounting for almost 90% or more of all heart attacks. Circulating cholesterol in our blood gets deposited within the inner linings of the blood vessels causing narrowing, a process known as atherosclerosis. Such narrowing, if severe enough, can lead to a compromise in the blood flow to the heart causing a heart attack. Atherosclerosis happens over the years and typically does not cause problem at younger age (males below age 50 years, or females below 60 years). Few of us are more likely to develop early atherosclerosis due to risk factors like genetic predisposition, smoking, poor lifestyle, Diabetes, high cholesterol, mental stress etc. In the absence of risk factors, the likelihood of having an atherosclerosis-related heart attack is exceedingly low at young age.

2. Blockages due to non-atherosclerosis: There are a few uncommon causes of blockages where cholesterol does not seem to play any role. These can be due to disruption in the smooth inner lining of the blood vessel (called ‘erosion’, typically seen in smokers), a tear within the walls of the blood vessel (called ‘dissection’), certain immunological diseases that affect blood vessels (called ‘arteritis’), infections, blood clot etc. Since these issues can occur at any age, a heart attack for the reasons above can occur at any age. We had seen a higher incidence of heart attacks during COVID-19 infection, which were thought to be due to blood clot formation.

3. Birth defects of the blood vessels: In rare cases, a birth defect where blood vessels may not be of appropriate size or may not follow a normal course, can lead to compromised blood flow to the heart. These abnormalities are present since birth and may cause a heart attack at a very young age.

As you can see from above, the majority of heart attacks are due to atherosclerosis which rarely cause any problem in people aged less than 50 years, in the absence of risk factors. ‘Early’ heart attacks can occur in those who have risk factors for developing premature atherosclerosis, or those with other causes as described earlier. As such, there cannot be an age cut-off for a heart attack, but chances of a heart attack at a young age are exceedingly low if one takes care of himself or herself.

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