Heart attacks can strike at a younger age: cardiologist

In the wake of the shock deaths of Kimberley Kitching and Shane Warne, a cardiologist explains why heart attacks in younger people are more likely to be fatal.

The deaths of senator Kimberley Kitching and cricketer Shane Warne, both at 52, have shocked those who believed heart disease was generally an affliction of the elderly.

But heart attacks among those in their 40s and 50s are not as uncommon as many might think – and when cardiac arrest strikes a younger person it may be more likely to be fatal.

In 2020, ischaemic heart diseases were the second-biggest killer of people aged 45 to 54. A total of 676 Australians died of heart disease in this age group, 544 of them men and 132 women.

“It’s not at all uncommon to see people with heart attack in their 30s, 40s and 50s,” says cardiologist Garry Jennings, the chief executive and chief medical adviser of the Heart Foundation. “Whilst the rates are higher with age, it can happen at any age in adults, and younger people are also more likely to die of their heart attack.”

The reason heart attacks are more likely to be fatal in younger people is probably related to the time it takes the arteries to find alternative routes of passage for blood when the main arteries are blocked by a buildup of plaque. When heart attack occurs later in life, the body has had more time to establish alternative pathways.

Shane Warne.

Senator Kimberley Kitching.

In most cases when a heart attack occurs, risk factors including high blood pressure, high cholesterol, diabetes and poor diet may be present.

But bafflingly, as may have been the case with Senator Kitching, a heart attack can come out of nowhere. Genetic factors are likely to be at play, and there is intense research into why heart attacks with no risk factors occur, looking at factors such as inflammation and blood clotting.

In women, when no risk factors are present, a sudden fatal heart attack is likely to be caused by a genetic condition known as spontaneous coronary artery dissection, which is tearing of the heart vessels, according to Jason Kovacic, the executive director of the Victor Change Institute.

The institute has extensive research under way to develop a risk score based on genetics. In the future, people will be able to be screened to determine their risk of having a heart attack.

About 200,000 women every year will have a heart attack in Australia and most fall into the 50-70 age bracket.

Heart attacks tend to strike men about a decade earlier than women.

Clara Chow, a cardiologist and president of the Cardiac Society of Australia and New Zealand, says the average age of heart attacks was 57 or 58.

Doctors are encouraging all people over the age of 40 to have regular heart checkups, which are Medicare-funded.