Heart attacks (also called myocardial infarction) in children, teenagers or at the young age of 20 or 30 years are not common, but they are seen. There are specific causes and risk factors that can cause a heart attack in such young individuals. Chest pain, therefore, in such individuals should never be ignored and should be investigated with an electrocardiogram or a stress test.
These include factors like family history of heart disease, smoking, high blood pressure, abdominal obesity, diabetes, a lifestyle of physical inactivity, and elevated levels of C-reactive protein (CRP).
Elevated CRP levels, per say, are not responsible for a heart attack, but they indicate a high level of inflammation in the body, which is associated with atherosclerosis.
They also indicate a significant effect of the risk factors such as hypertension, smoking, family history, obesity on the body. Elevated CRP levels tell your doctor that your risk of a heart attack is significantly advanced.
Of all the risk factors mentioned here, smoking could be the most common cause contributing to a heart attack in the young age. Smoking also promotes the formation of blood clots, which clog the arteries and block blood supply. Other causes are explained below.
Specific heart attack causes in children, teenagers, and young adults
The heart attack causes mentioned below are seen in children, teenagers, and young adults
Coronary arterial anomalies
Coronary arterial anomalies are congenital abnormalities involving the origin, course, and structure of the epicardial coronary artery, which is one of the arteries that supplies blood to the heart wall. Such anomalies are often associated with other congenital heart defects.
The most common congenital anomaly is called ALCAPA, which stands for an anomalous left coronary artery from the pulmonary artery.
Normally, both the coronary arteries originate from the aorta, which carries richly oxygenated blood. In ALCAPA, the left coronary artery originates from the base of the pulmonary artery, which carries deoxygenated blood. This improper perfusion of the heart with the wrong blood carries a very high risk of a heart attack.
A blood clot can travel from elsewhere in the body usually where an atherosclerotic plaque has ruptured and get lodged in one of the coronary arteries. This will occlude the artery and block the blood flow to the heart muscle wall causing a heart attack.
Blood clotting disorders
Many factors can cause clotting disorders (thrombophilia) in which excessive blood clots form in your body. The genetic factor is one such cause though it is less common. Usually, in such cases, there is a defect in the proteins that are required for blood clotting leading to an improper control on clot formation.
Other risk factors that cause excessive blood clots to form are
- Smoking causes the platelets in the blood to stick to each other promoting the formation of blood clots.
- Long hours of sitting such as on a long flight can cause deep vein thrombosis, in which the clot from the lower extremities can get dislodged and travel to the heart.
- Prolonged hospitalization is another factor, which can cause clots to form in a similar way.
- Use of birth control pills or hormone replacement therapy
- Atrial fibrillation in which the upper chambers of the heart beat at a fast and irregular rhythm promotes clot formation
- Pregnancy can cause excessive blood clots to form due to an increase in the platelet count and other clotting factors. The enlarged uterus can also compress on the neighboring veins slowing blood flow and increasing chances of clot formation.
Coronary artery spasm
Coronary artery spasm is a localized squeezing of the smooth muscle in the wall of the coronary artery. It is more often seen in people who smoke or in people with high cholesterol or in people with high blood pressure. Stress, cold weather, vasoconstrictor drugs and use of stimulant drugs such as amphetamines and cocaine can trigger coronary artery spasm.
Blunt chest trauma can cause a cardiac contusion, which can precipitate a heart attack.