Experts reveal the two groups of women most at risk of sudden, catastrophic heart attacks – despite being young and ‘healthy’

Thousands of healthy young women who are not pregnant and those going through the menopause could be at increased risk of sudden heart attack, new research suggests.  

The condition – known as spontaneous coronary artery dissection (SCAD) – is unusual because it most commonly affects those with no obvious risk of heart disease. 

Previously, it has been suggested that women are most at risk of the devastating condition as a result of extreme exercise, pregnancy or labour. 

But now experts from the University Clinical Center Niš, in Serbia, have warned that menopausal and healthy young women could also be at risk of sudden heart attack. 

The condition occurs when one or more of the inner layers of a coronary artery – which supply blood to the heart – tears away from the outer layer.

Blood is then able to flow into this gap and a blood clot forms, reducing blood flow to the heart. This can lead to a heart attack or cardiac arrest, when the heart suddenly stops pumping blood around the body. 

Presenting their findings at the European Association of Percutaneous Cardiovascular Interventions Summit, Professor Svetlana Apostolović said: ‘SCAD is an increasingly recognised cause of acute coronary syndrome (ACS), but it remains poorly understood.

‘lt remains under-diagnosed and under-studied with few, if any, randomised trials conducted to define the most appropriate treatment approach. 

‘We found that SCAD was most common in non-pregnant young women and menopausal women.’ 

The cardiology professor added that blood-pressure monitoring – as well as medication and psychological support following a major heart event – could help improve outcomes and reduce the risk of these women suffering a heart attack. 

The study analysed data from 123 patients on the Serbian SCAD registry who were treated at 14 specialist heart center between November 2021 and 2024.

Of these, 27 patients were studied retrospectively, while 96 were monitored in real time. 

Intracoronary imaging techniques – which allow doctors to look inside the heart’s blood vessels to get a clear picture of the artery wall – was used to confirm SCAD in 26 per cent of patients. 

More than 85 per cent of those diagnosed were women, who were around 48-years-old. 

Around 7 per cent were pregnant or had recently given birth, whilst over a third were menopausal. 

Whilst most people with SCAD do not have common risk factors for heart disease – such as smoking, diabetes and high cholesterol – the findings revealed half of those diagnosed had high blood pressure.

 When blood pressure is high for too long, it can damage the walls of blood vessels, resulting in plaque build-up and restricted blood flow to the heart. 

High cholesterol, which was identified in 46 per cent of participants, can also increase the risk of heart attack as fatty deposits build up in the arteries, causing them to narrow and harden. 

However, the researchers stressed that the condition is spontaneous, meaning that it is not something that is easy to predict.  

Where a trigger was identified following a heart event, the most common contributing factors were mental or emotional stress, affecting nearly 40 per cent of patients, and physical exertion. 

Treatment for SCAD varies depending on how severe a patient’s symptoms are but most will be prescribed medication to prevent blood clots – as was the case for more than half of patients in the study. 

Just over 40 per cent underwent a procedure to open the artery, which for many involved having a stent inserted to improve blood flow to the heart. 

During their hospital stay, around a quarter of patients suffered a major heart event, such as another heart attack, heart failure or stroke, 8 per cent of which were fatal.

In the 30 days after discharge, less than 20 per cent experienced a major heart event, which researchers said were more common in those had received a stent or suffered from depression. 

Just one month after treatment, around 62 per cent of patients showed no signs of SCAD. 

Prof Apostolović concluded: ‘Careful observation alongside beta-blockers, blood pressure lowering medication, cardiac rehabilitation and psychological support may improve outcomes and reduce the impart on patients daily lives, but more studies and trials are needed.’ 

Cardiovascular disease is one of the leading causes of death globally, claiming an estimated 17.9million lives each year.

With at least four SCAD heart attacks occurring every day in the UK, this means approximately 1,4000 people could be suffering potentially life-threatening attacks due to the little-known condition each year. 

Common symptoms are very similar to those of a heart attack including chest pain, tightness or pain in the arms, neck, jaw, or back, feeling dizzy, tired or out breath and nausea.  

The Daily Mail has previously highlighted how the number of young people under 40 in England being treated for heart attacks by the NHS is on the rise.

Factors such as slow ambulance response times for category 2 calls in England — which includes suspected heart attacks and strokes — as well as long waits for tests and treatment have also been blamed for the worrying reversal in progress.