Acute myocardial infarction in young women: current perspectives

Abstract

Acute myocardial infarction (AMI) is the leading cause of death in women worldwide. Every year, in the USA alone, more than 30,000 young women <55 years of age are hospitalized with AMI. In recent decades, the incidence of AMI is increasing in younger women in the context of increasing metabolic syndrome, diabetes mellitus, and non-traditional risk factors such as stress, anxiety, and depression. Although women are classically considered to present with atypical chest pain, several observational data confirm that men and women experience similar rates of chest pain, with some differences in intensity, duration, radiation, and the choice of descriptors. Women also experience more number of symptoms and more prodromal symptoms compared with men. Suboptimal awareness, sociocultural and financial reasons result in pre-hospital delays in women and lower rates of access to care with resulting undertreatment with guideline-directed therapies. Causes of AMI in young women include plaque-related MI, microvascular dysfunction or vasospasm, and spontaneous coronary artery dissection. Compared with men, women have greater in-hospital, early and late mortality, as a result of baseline comorbidities. Post-AMI women have lower referral to cardiac rehabilitation with more dropouts, lower levels of physical activity, and poorer improvements in health status compared with men, with higher inflammatory levels at 1-year from index presentation. Future strategies should focus on primary and secondary prevention, adherence, and post-AMI health-related quality of life. This review discusses the current evidence in the epidemiology, diagnosis, and treatment of AMI in young women.

The Characteristics of Risk Factors in Chinese Young Women with Acute Coronary Syndrome

“…hypothyroidism gynecological diseases, depression or anxiety, cardiac insufficiency, and oral contraceptives, family history of early onset CHD and autoimmune diseases are independent risk factors. This is the main characteristic of risk factors in young women with ACS [16] . In the ACS group, the distribution proportion of these risk factors was significantly higher than that in the control group (P < 0.01).…”

“…15 The uric acid value > 375umol/L on admission was recorded as hyperuricemia. (16) It was recorded as renal artery stenosis that the patients with high blood pressure and with one or bilateral renal artery blood vessel diameter stenosis ≥ 50% by renal artery color ultrasound or by CT renal artery vascular imaging or by invasive renal artery angiography or by undergoing renal artery stent implantation. 17 It was recorded as hypothyroidism that patient was suffered from hypothyroidism and was taking thyroid hormone therapy or plasma thyroxine level was lower than the normal level and thyrotrophin was elevated at the same time.…”

“…Epidemiological investigations have shown that acute coronary syndrome (ACS) is the leading cause of death in women [1] . Because of the effect of estrogen, the onset age of coronary heart disease is 10 years later than that of men, and the occurrence of serious clinical events (such as myocardial infarction or sudden death) is 20 years later than that of men [2] In the last twenty years, the annual mortality rate for young women with CHD has increased by an average of 1.3 percent [3,4] In this paper the age division of peoples is based on the new age segmentation proposed by the World Health Organization in 2017.The age of young people is 44 and under 44 years old, middleaged people is between 45 and 59 years old, young elderly people is between 60 and 74 years old, elderly people is between 75 and 89 years old, and the old longevity people is above 90 years old.…”

Atypical Presentation of Myocardial Infarction in a Young Patient With Polycystic Ovarian Syndrome

“…Myocardial infarction is the leading cause of death in women worldwide [3]. Postmenopausal women were affected the most, but it is also found to be increasing in younger women [7].…”

“…Polycystic ovarian syndrome (PCOS) is one of the common endocrinopathy noted in women of childbearing age groups, with a prevalence ranging from 4% to 12% globally [1]. Patients with PCOS have insulin resistance, dyslipidemia, obesity, androgen excess, and infertility [2][3][4]. All these are risk factors for cardiovascular diseases.…”