Heart attack at 23

What It’s Like to Have a Heart Attack in Your 20s or 30s

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When you picture the typical heart attack patient, it’s probably an older man clutching his arm and grimacing in pain. But the truth is, heart disease isn’t just a man’s condition—it’s also the leading killer of women, claiming about one in every four females’ lives in the United States, according to the Centers for Disease Control and Prevention.

And while it’s true that our risk of having a heart attack increases as we age, younger women are not immune to them. In fact, the Women’s Heart Foundation says that of the 435,000 American women who have heart attacks annually, 8% of them of them are younger than 55.

What’s more, heart attacks under 50 are twice likely to be fatal for women as they are for men, possibly because women often ignore early warning signs. In a 2015 study published in Circulation: Cardiovascular Quality and Outcomes, Yale University researchers interviewed women aged 30 to 55 who survived a heart attack and discovered many of the women brushed off pain, dizziness, and other symptoms. Additionally, a 2013 study published in JAMA Internal Medicine revealed that many younger women who survived heart attacks never experienced any chest pain.

Be sure to read more about the heart attack symptoms women should never ignore—knowing how to spot them could save your life, or someone else’s. And remember, women can suffer from heart attacks even when they’re in their 20s and 30s. The following three women know from experience, and share their harrowing stories.

Kara Burns, 41, had a heart attack at age 39

As a former cardiology nurse, I knew all about the symptoms of a heart attack. But that was the farthest thing from my mind when I was hit with sudden chest pain one morning in 2013.

It was just a normal Saturday; I was sitting in bed with my husband and three-month-old baby, watching the news and drinking coffee. Looking back, I had all the classic symptoms: I felt dizzy and nauseous, and the chest pain was radiating out to my back. I knew something was wrong—and I knew I needed to get to the hospital—but I didn’t think I was having a heart attack.

I was just about to get into my car when I turned to my husband and said, “I’m not going to make it.” That’s when he called an ambulance, which was there in about two minutes. The firefighters came, too—they were rearranging my furniture in my living room while the EMTs put me on a gurney. They kind of swooped me away and we were off to the hospital. My husband was following behind the ambulance in my Toyota Highlander—later, he told me, “I didn’t know your car could do 95 miles per hour on the highway.” I had no idea how fast we were going.

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At the hospital, they took me into the trauma room right away. I only remember bits and pieces of the next 24 hours. I was an emotional wreck, so they kept me pretty sedated. I remember waking up and seeing my mom, waking up and asking where the baby was.

I was in the hospital for a total of five days, and used some of that time to research what had happened to me. The doctors were saying, “I’ve only seen one of these in my career,” or, “I’ve read about something like this, but I’ve never seen it.” I later learned that I had suffered a spontaneous coronary artery dissection, which occurs when a tear forms in a blood vessel. The tests also showed that I had fibromuscular dysplasia, a condition in which there are abnormal cell growths in one or more artery walls.

It was frustrating—I never smoked and didn’t have a family history. I kept thinking, “What did I do to cause this?” And I couldn’t do things I once did anymore, like carry my baby up the stairs. But time heals all things. I started going up to the Mayo Clinic in Rochester, Minn., and got involved with the WomenHeart organization. For years, never wanted to talk about it, but now I do so openly. I’m finally getting the strength to share my story.

Rolanda Perkins, 50, had a heart attack at age 39

There were a lot of things on my mind in the week leading up to my heart attack, but my symptoms weren’t exactly one of them. At the time, I was under a lot of stress: pulling the midnight shift at my job at a child-abuse hotline, while also planning a huge surprise party for my sister. I wasn’t sleeping well, and I internalized a lot of that pressure.

A week before the party, I started coming down with really bad headaches. Still, I self-medicated with Excedrin and I brushed it off as a migraine. I figured that I was just tired, and it would go away after everything calmed down.

I had a heart attack the day after the party, on a Sunday. I was mopping the floor when, all of a sudden, I felt a sharp pain in my chest. I’d never felt anything like that before. I thought maybe it was intense indigestion. And I remember thinking, “I’ll go to bed and deal with it tomorrow.” That didn’t happen: The pain was so bad that it woke me up at around 3:30 in the morning, and a friend drove me to the hospital. When I got there, the tests showed that I was having a heart attack, and the doctors performed an angioplasty—a procedure in which a small tube is inserted into the artery to help prop it open.

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After I was discharged, I felt alone and confused. I’d never known anyone who’d had a heart attack at my age before—even my doctor didn’t give me the support I needed. That was a hard time for me, but I also knew that I had survived this for a reason. So I began volunteering: First I met with women’s health organizations, and then I eventually started a chapter of WomenHeart-Nashville Music City in Nashville, Tenn., where women who’ve had heart attacks can help each other work through their diagnoses. I felt that there was a lack of resources for women like me, and I want to provide that for others. I even switched health care providers, too, and am much more satisfied with the help I’m getting now. To this day, I tell everyone, “You know your own body. If something’s wrong, listen to it.”

Eve Walker, 44, had a heart attack at age 28

I was 12 years old when my sister—we called her “Sugar”—died all of a sudden at a party. She was 16. There wasn’t a full autopsy, but the early findings pointed to heart disease—something I never learned until I was an adult. My family never talked about the incident. It completely changed my life, but for years, we just quietly went on.

Sixteen years later, I started experiencing heart disease symptoms, too, though I didn’t recognize them at the time. The first thing I noticed was that I couldn’t walk up an incline without feeling short of breath. I couldn’t understand it; I was a size 6 and had been dancing all my life. So I went to the doctor and said, “I think I have adult asthma.” They ran tests—which came back negative—and I left thinking, “I need to get in better shape.”

Not long after that, I started feeling dizzy at work and noticed that my legs felt like tree trunks: so heavy that it was hard to walk. I felt so bad that I went straight to the emergency room from the office. One of the nurses asked me if I was on drugs and gave me an aspirin. A few days (and many aspirins) later, I was so winded that I couldn’t climb a flight stairs at my house. I turned around and thought, “My mom’s place doesn’t have stairs—I’ll go there instead.” Two days later, I had a heart attack.

I distinctly remember it happening—I was watching the first season finale of American Idol at a neighbor’s house, when I suddenly felt a sharp pain in my leg. I thought it was a mosquito bite at first, but then the pain began to travel up the left side of my body. Once it reached my jaw, I realized that I was having a heart attack. My neighbor put me in her car and rushed me to the hospital, which was about two miles away.

One day after I was admitted, the doctors gave me a heart catheterization. They diagnosed me with hypertrophic cardiomyopathy, which is an enlarged heart muscle that limits the body’s ability to pump blood.

After I was discharged, I went through a depression and developed insomnia. I learned that I have to take medication every day for the rest of my life, and I was scared that I was going to die in my sleep. No one ever tells you that this is your new life, that this is your new normal.

Gradually, though, I adjusted. Prayer helped. I’ve always been a spiritual person, and being around spiritual people helped me realize that I had a purpose and a destiny. I got involved with the American Heart Association and began helping to educate women about heart disease.

Now I use every opportunity I have to inspire others. Every day I wake up, I’m like, “I’m here!” I want to help people navigate their lives and not let a diagnosis stop them. It won’t stop me.

A shock to the system

Hannah Wrigley was just 26 years old when she had a heart attack.

“My heart attack was completely unexpected. I was cleaning one Tuesday morning, and I started coughing rather dramatically. I suddenly collapsed to the ground with the worst imaginable burning in the centre of my chest and a crushing pain.” A few hours later Hannah experienced a heavy left arm and a persistent feeling of pressure in her chest as well as feeling intensely nauseated.

When an ambulance arrived, the ECG read ‘acute MI (heart attack) in progress’. Despite this, it was not until Hannah underwent an angiogram a number of hours later that doctors agreed about her diagnosis, simply due to her age and lack of risk factors. Delays in treatment, especially in young women whose MIs are not recognised, can significantly affect outcomes.

Hannah has since been found to have antiphospholipid syndrome, a tendency for her blood to clot more than usual. Before the heart attack Hannah was a strict vegan and not overweight but says she was an anxious, highly strung person. The heart attack has made her revaluate and reassess her priorities.

Taking appropriate action

The heart attack resulted in her making physical changes, including starting to eat oily fish and doing gentle yoga and Pilates. In addition, she reassessed her health behaviours and reduced a stressful lifestyle. “I had a huge mental shift and reassessed my priorities, reducing levels of stress.”

She is also on medication to reduce the risk of her blood clotting again in the future and knows the signs and symptoms to look for. These signs include central crushing chest pain, or a heaviness or discomfort that may spread into the left arm, breathlessness, and nausea or grey tinge to your complexion. Importantly, women are less likely to get the ‘classic’ central crushing chest pain we see people collapsing with in TV soaps. Instead, symptoms in women are often more vague – another possible reason for higher death rates among women. Knowing the signs can save lives.

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Cardiac health in those who are active

Keeping active is thought to help keep your heart healthy. It is thought that being physically active can decrease your chance of heart disease or stroke by up to 50%, a fantastic incentive for people to get active. Regular exercise can help lower blood pressure, reduce the risk of type 2 diabetes, help control weight and improve your general health and well-being as well.

People who are very physically active (more than five hours of intense exercise a week) may develop an athlete’s heart (athletic heart syndrome). This is a normal physiological change in their heart that takes place over time in response to exercise.

The heart becomes enlarged and beats more slowly, pumping more blood each time it beats. No treatment is required for people with athletic heart syndrome and it does not pose any physical threats to the athlete. However, if these signs (slow heartbeat and an enlarged heart) occur in a non-athletic person, they need to be thoroughly investigated.

Sudden cardiac death in athletes

Sudden cardiac death is a natural unexpected death from a cardiac arrest (the heart stopping), and usually it occurs during exercise. As scary as it is seeing somebody like Fabrice Muamba collapse in the middle of a Premier League football match, it is very rare.

Usually it is caused by either an inherited heart condition or cardiovascular disease (a heart attack) even if the person is physically fit.

It is important to remember that sudden cardiac death is extremely rare, but if you are concerned, please speak to your doctor. This is especially important if you have a family history of cardiac problems or unexplained collapses. Often, there are no preceding symptoms but there does appear to be a link in some athletes who experience fainting or near fainting during exercise. If this is the case or you are concerned please see your doctor for advice.

For nearly all individuals, regular exercise is very beneficial to the health of the heart, resulting in better heart health. However, as illustrated by Hannah’s story and those of athletes who suffer sudden cardiac death, heart disease can affect the young as well, so it is important to be aware of the signs and symptoms.

Does Chest Pain Always Mean Heart Attack?

Is it possible for a 22-year-old male to have a heart attack? Or is there any other reason for a guy this age to have chest pains? Could it be serious?

— Joyce, California

There are many reasons why a 22-year-old could have chest pain. And while it’s quite rare, a heart attack can occur in a person in his twenties. You may remember the popular Russian Olympic pairs figure skater Sergei Grinkov, who died of a heart attack in 1995 at age 28 while practicing for a performance. His only symptom was back pain and yet an autopsy revealed that he had severely clogged coronary arteries. Further DNA testing showed that he had a rare genetic risk factor linked with premature heart disease. (Grinkov’s father died of a heart attack at age 52.)

He was in great shape at the time he died and had none of the typical risk factors associated with heart disease, such as elevated cholesterol or triglyceride levels, high blood pressure, diabetes, or being sedentary.

Besides family history and the other risk factors mentioned above, potential causes of heart disease and heart attack in a young person could include a congenital heart abnormality or an unusual problem with blood clotting. By far the most common risk factor in young heart attack patients, as compared to older patients, is smoking. Because smoking tends to promote blood clots, it can cause a heart attack even in those without extensive underlying atherosclerotic plaques.

Bear in mind, however, that chest pain is not always caused by a heart problem. For example, conditions like acid reflux (GERD, or gastrointestinal reflux disease), irritation of the diaphragm (the muscle below the chest that allows us to breathe), and certain viral or bacterial infections can also produce this discomfort.

Indeed, almost everyone experiences some kind of chest discomfort or shortness of breath from time to time. But if a patient of any age tells me that he or she is suddenly panting or experiencing unusual chest pain while doing a regular workout on a treadmill or while running to catch a plane, for example (in other words, the person’s regular exercise capacity has definitely decreased), I become concerned and will likely do an exercise stress test to see what’s going on. This test helps me figure out whether the symptoms are coming from sluggish blood flow due to a blockage in one or more of the coronary arteries.

A stress test is just one of several tests a doctor can perform to rule out heart disease. The physician can also do an electrocardiogram (EKG or ECG) — a simple, noninvasive, completely painless test that takes just minutes — and look for changes on the tracings that indicate compromised blood flow to the heart. Furthermore, when the heart is injured from the inadequate blood flow that causes a heart attack, enzymes leak from the affected tissue and can be measured by a simple blood test.

The bottom line: While it’s unlikely that chest pain in a 22-year-old is due to or will result in a heart attack, it is best not to take any chances and to consult a physician. Don’t self-diagnose!

Learn more in the Everyday Health Heart Health Center.

(Kittisak Jirasittichai / EyeEm, Getty Images)

Heart attacks – once characterized as a part of “old man’s disease” – are increasingly occurring in younger people, especially women, according to new research.

The study presented Sunday at the American Heart Association’s Scientific Sessions meeting in Chicago and published in the AHA journal Circulation, sought to investigate heart attacks in the young, a group frequently overlooked in cardiovascular research.

Past research has shown heart attack rates in the U.S. have declined in recent decades among 35- to 74-year-olds. But for the new study, researchers wanted to look specifically at how many younger people were having heart attacks.

They included data from a multi-state study of more than 28,000 people hospitalized for heart attacks from 1995 to 2014. The results showed 30 percent of those patients were young, age 35 to 54.

More importantly, they found the people having heart attacks were increasingly young, from 27 percent at the start of the study to 32 percent at the end.

“Cardiac disease is sometimes considered an old man’s disease, but the trajectory of heart attacks among young people is going the wrong way. … It’s actually going up for young women,” said Dr. Sameer Arora, the study’s lead author. “This is concerning. … It tells us we need to focus more attention on this population.”

Among women having heart attacks, the increase in young patients went from 21 percent to 31 percent, a bigger jump than in young men. Researchers also found that young women had a lower probability than men of getting lipid-lowering therapy, including antiplatelet drugs, beta blockers, coronary angiography and coronary revascularization.

“Women were not managed the same way as men, and that could be for a combination of reasons,” said Arora, a cardiology fellow at the University of North Carolina School of Medicine.

“Traditionally, coronary artery disease is seen as a man’s disease, so women who come to the emergency department with chest pain might not be seen as high-risk,” he said. “Also, the presentation of heart attack is different in men and women. Women are more likely to present with atypical symptoms compared to men, and their heart attack is more likely to be missed.”

Dr. Ileana L. Piña, a cardiologist who was not involved in the research, called the study “another wake-up call to physicians, especially male physicians” to pay attention to the symptoms of heart disease in women.

“The number one killer of women is not breast cancer or uterine cancer; the number one killer of women is heart disease,” she said. “And until we pay attention to this, these kinds of figures are going to keep coming up.”

Piña and Arora both said they would like to see women better represented in future studies on heart disease.

“It’s very important to enroll enough women so we can actually take a look at the female population separately,” said Piña, a professor of medicine and epidemiology at Montefiore Medical Center in New York City.

The study also found that high blood pressure and diabetes were rising among all patients who had heart attacks. Compared with young men in the study, young women were even more likely to have high blood pressure, diabetes and chronic kidney disease.

“With the weight issues we have in this country, we have diabetes and hypertension coming along with it. I tell my patients very clearly, ‘You need to get your weight down and move and exercise,'” Piña said.

But focusing on your health can be particularly challenging for women because of long-held gender beliefs about parenting and household work, she said.

“It’s hard when a woman is working two jobs and taking care of the family, too,” Piña said. “They’ll do anything for their families, but they often leave themselves for last. We need to teach women to change their health attitude and take care of themselves. If they don’t do well, their families won’t do well either.”

Find more news from Scientific Sessions.

If you have questions or comments about this story, please email [email protected]

Learn more about heart disease in women

Boy, 13, is youngest heart attack victim

One of the doctors told Zhen Siong’s family that the previous youngest heart attack victim was 27 years old.

He said that Zhen Siong’s death was an unusual case.

Zhen Siong’s uncle Yu Bao said the Form One boy was larger in build compared to other boys his age.

“Standing close to six feet, Zhen Siong loved to play basketball,” he said.

He added that Zhen Siong complained of chest discomfort after a camping trip at the end of last month, but none of the family members had even thought that it was possible for the 13-year-old to have a heart problem.

Accidental possibilityAt first, foul play was suspected but now police say that a 26-year-old army captain, fighting for his life after suffering 80% burns, may have accidentally caused the fire.

China Press reported that Hisyamudin Sahidan is believed to have crawled out from his burning car parked in the basement of a shopping centre in Jalan Bukit Bintang early Sunday morning.

Kuala Lumpur city CID chief Senior Asst Comm (II) Ku Chin Wah said police had initially investigated the case as attempted murder but the Chemistry Department’s report had ruled this out.

The newspaper said it was believed that a drunk Hisyamudin was smoking in his car and that the fire could have been started by a burning cigarette butt.

A soldier, in his 30s, detained by police in connection with the case was released on Tuesday evening.

Other News & Views is compiled from the vernacular newspapers (Bahasa Malaysia, Chinese and Tamil dailies). As such, stories are grouped according to the respective language/medium. Where a paragraph begins with a sub-heading, it denotes a separate news item.

THURSDAY, March 7, 2019 (HealthDay News) — Although Americans are suffering fewer heart attacks, the rate is dramatically increasing among those under 40.

In fact, 20 percent of people who have a heart attack are 40 or younger, a rate that has risen 2 percent a year for 10 years, new research reports.

Some of these people are now in their 20s and early 30s, said senior study author Dr. Ron Blankstein, a cardiologist at Brigham and Women’s Hospital in Boston. He said it used to be “incredibly rare” to see anyone under age 40 with a heart attack.

“Based on what we are seeing, it seems that we are moving in the wrong direction,” he said.

These young heart attack victims also have the same risks of dying from another heart attack or stroke as older patients.

“Even if you’re in your 20s or 30s, once you’ve had a heart attack, you’re at risk for more cardiovascular events and you have just as much risk as someone who may be older than you,” Blankstein said.

Risk factors such as diabetes, high blood pressure, smoking, family history of premature heart attack and high cholesterol were the same among older and young people who suffered a heart attack, researchers found.

Younger patients drank less alcohol but were more likely to be substance abusers — 18 percent used marijuana and 9 percent used cocaine.

For the study, Blankstein and colleagues collected data on close to 2,100 patients under age 50 admitted to two hospitals for heart attacks.

“Many people think that a heart attack is destined to happen, but the vast majority could be prevented with earlier detection of the disease and aggressive lifestyle changes and management of other risk factors,” Blankstein said

To protect yourself, he recommends avoiding tobacco, getting regular exercise, eating a heart-healthy diet, losing weight if you need to, managing your blood pressure and cholesterol, avoiding diabetes, and staying away from cocaine and marijuana.

In a related study, Blankstein’s team found that 1 in 5 patients who suffer a heart attack before age 50 also have diabetes. Diabetics are more likely to have repeated heart attacks and die from a heart attack than other people.

These patients need aggressive treatment, Blankstein said. Some diabetes medications can reduce heart attack risk, he added.

The findings are to be presented March 17 at the American College of Cardiology’s annual meeting in New Orleans. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

Heart Attacks Can Strike Young Adults, So Know the Signs

Heart attack via

Chest pressure. Shortness-of-breath. Cold sweats. Individually, these symptoms could be signs of heatstroke, asthma or even the side effects of an emotional outburst. But collectively, they can be misdiagnosed signs of a heart attack especially if you re someone under 40.

Scientists speculate that silent, undetected disorders of the heart s pumping rhythm, along with premature heart disease, account for many of the sudden cardiac events (SCE) in younger, seemingly healthy individuals.

Take marathoner Angela Parker who, at just 22, experienced all of the above mentioned while on a trip through Africa. So young at the time, doctors brushed off her symptoms as the flu. Or Joseph Collins, a teenage baseball player who collapsed 10 years ago while running wind sprints with his high school teammates. His coaches stood silently as they watched the then 14-year old fall to the ground failing to act because they thought his tumble was a result of his workout.

Each survived their own frightening ordeal. But what these two unfortunate cases allude to is compelling evidence that when it comes to SCE, no one is immune.

The Centers for Disease Control reports that heart disease is the leading cause of death for both men (especially during the ages 45-54, and 65+) and women (ages 65+). What’s more, one in every four deaths are because of it.

Roughly 735,000 Americans experience a heart attack annually irrespective of age. And while most heart attack victims are middle-aged or older the average age for a first-time heart attack is 66 for men and 70 for women those in their 20s and 30s suffer them as well. The Women’s Heart Foundation says that annually 35,000 women under the age of 55 experience a heart attack, and that women are twice as likely as men to die within the first few weeks after being stricken.

There are two different yet equally dangerous underlying causes of heart disease, which can cause a heart attack in both men and women under age 40: Kawasaki disease and hypertrophic cardiomyopathy.

Kawasaki disease

A rare childhood disease, Kawasaki involves inflammation of the blood vessels such as the arteries, capillaries and veins. Sometimes Kawasaki disease affects the coronary arteries, which carry oxygen-rich blood to the heart. Children who had it, like Ms. Parker, may develop serious heart problems later on. And it was only after her second heart attack at age 24 that doctors were able to pinpoint Kawasaki as the underlying cause.

Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is a common cause of heart attacks in young people, including young athletes, and is usually inherited. Caused by a mutation of the genes in the heart muscles, the condition is characterized by enlarged cardiac muscle cells. This enlargement causes the walls of the ventricles (the heart’s “pump”) to thicken, which can block the blood flow. The ventricle must then work harder to pump the blood flow making physical activity unsafe, and often this escapes early detection, as in the case with Mr. Collins.

He received a physical one week prior to him collapsing on the field,” said Collins’ mother, Eva. “And unfortunately they don t do the ECGs and echos, referring to heart checkup testing.

Lastly, threats to heart health can, of course, also be brought on by lifestyle choices. Smoking is by far and away the biggest threat, which is why it’s the behavior that should be corrected first and receive the most attention. Being overweight or obese is another significant factor. Lack of physical activity can also undermine the heart, as can abuse of illegal drugs. And for someone who is diabetic, inattention to this serious condition can also pose a risk to the heart.

And without a doubt, while young adults are stricken with heart attacks far less frequently than older adults, they should be mindful of these symptoms that might signal an oncoming attack: chest pain, shortness of breath, cold sweats, nausea, jaw pain and vomiting.

And while you don’t have control over inherited conditions such as Kawasaki disease and Hypertrophic cardiomyopathy, you do have control over the lifestyle choices you make. So make good ones.

I was sick, but that was to be expected. The New Year’s Eve party had been a good one: 2007 had been a tough year; I had got through four separate operations, each one longer and more involved than the one before. I had been changed, worn a bit thin, and was suffering small bouts of depression. But I was still standing. A new year was to be celebrated.

So when I woke up sick, I put it down to the excesses of the night before. There had been a lot of laughter, music, and cheap wine. It had been a fun party – I never claimed it was a classy one.

I felt sick, but it wasn’t a normal sort of nausea. It was a sickness which left me panting and breathless. As the pain in my breastbone increased, and my arm felt as though it had been punched until it was dead, I began to realise something was wrong. Very wrong. I told my husband I thought I was having a heart attack. Understandably, he laughed and told me I had a hangover.

I just needed to sleep it off and I would be fine.

So that’s what I did. I rolled over and breathed slowly, forcing myself calm until sleep took me away from the pain. I never truly believed that, at not even 30 years old, I could actually be having a heart attack. So I slept, and when I woke up in the early evening, I felt a bit better. Well enough to tell myself I had been overreacting; I just needed to calm down at parties – a thought that tied in well with my resolution to live more healthily.

The next days turned into weeks, and weeks became months. I went from being healthy, to being very, very ill. Yet fear stopped me going to the doctor. Not fear of looking stupid, but fear that my suspicions were correct. That I had something seriously wrong with me, and this time it couldn’t be cut away.

I didn’t go to the doctor until July. It took me that long to admit to myself, and my family, that I didn’t have late-onset asthma, or severe heartburn. By this point, I couldn’t leave my house at all. Some days I couldn’t leave my bed. Most days my mother, disabled and in pain, had to travel a mile to get my infant daughter from a school less than 300 metres from my front door. I was sick constantly. My heart felt like a leaden weight tucked behind my ribcage, and I could feel its torturous heavy beats in my skull. By the time I broke down in the doctor’s office it felt as though I was staying alive through sheer force of will.

I was right. It was one of the rare times where being right was no victory. My doctor listened to me as I explained my “hangover” and how I had been feeling worse with each passing day. As I spoke, he called the nurse, and before I had mentioned having a sick bucket as a constant companion, he had me walking – slowly – down the stairs to be hooked up to an ECG machine. I was still saying I was sure I was overreacting as he phoned the hospital, booking me in urgently. I think I was still telling doctors I was sure it was nothing as nitroglycerin was sprayed under my tongue for the pain and I was wheeled into theatre for an emergency angiogram. Dye was injected into my heart and I watched the images unfurl on the screens next to me.

As a surgeon spoke, telling me words too big for me to grasp, I nodded as I cried, signing consent forms and blanking out the risks of angioplasty even as they were being explained to me. I cursed myself for being stupid – for leaving it all so long. It was a terrifying time, as I became used to a changed reality. A slower life.

‘I was still saying I was sure I was overreacting as they hooked me up to an ECG machine.’ Photograph: Universal Images Group Limited/Alamy

The following year, as Big Ben chimed in 2009, I raised my glass with a thanks more heartfelt than before, amazed I was still standing. Changed, absolutely, but still laughing, while the music still played and my heart still beat. That New Year’s Day, I was able to jump out of bed and walk along the beach, thankful to be alive.

The heart attack taught me, profoundly, not to take my health for granted, and not to sweat the small stuff. My weight bounces up and down, and I suffer from water retention; I don’t like the way I look now, bloated and larger than before, but it’s something I can take time to fix. I tell myself it won’t be for ever. A lot of the little things I do – writing, sewing and knitting – help me to cope, and to feel useful since my health problems forced me to stop working. No one would employ me now, not when a “bad day” means I can barely roll over in my bed without needing nitroglycerin.

I take my health seriously now. I walk for miles with my dog, and I’m tuned in to what “normal” means for me. I pick up the small signs that I’m not well sooner than I would have done before. When I suffered a serious bout of pneumonia I called an ambulance the moment I found it difficult to breathe. That lesson has been learnt. I eat healthily – low fat, low salt, low sugar, lots of vegetables. I cook simply, and I live each day as it comes; when I raise a glass now, I do so with feeling. And when I wake up each morning, I take just a small moment to smile to myself, tell myself that life is good, that I made it through another night.

Compared to MI patients in their 40s, younger individuals were more likely to have single-vessel disease but were equally likely to experience adverse outcomes, including death, following their heart attacks. They were also nearly twice as likely to report substance abuse, including marijuana and cocaine (17.9 percent vs. 9.3 percent), but had less alcohol use.

Blankstein noted there was a trend toward fewer aspirin or statin prescriptions for patients who were 40 or younger, which may reflect a bias from physicians who are falsely reassured by their age.

“Many people think that a heart attack is destined to happen, but the vast majority could be prevented with earlier detection of the disease and aggressive lifestyle changes and management of other risk factors,” Blankstein said. “My best advice is to avoid tobacco, get regular exercise, eat a heart healthy diet, lose weight if you need to, manage your blood pressure and cholesterol, avoid diabetes if you can, and stay away from cocaine and marijuana because they’re not necessarily good for your heart.”

In a related study, Blankstein and colleagues found 1 in 5 patients who were admitted for a heart attack at age 50 or younger had diabetes. That work will also be presented at the ACC’s scientific sessions, according to the release.

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