Myocardial Infarction – A Growing Menace in India

The increasing prevalence of Myocardial Infarction (MI) in people less than 45 years of age is significantly alarming. According to experts, there is a relative scarcity of data on premature coronary heart disease (CHD) and MI in the young, but there are now a growing number of patients having MI at a relatively young age.

According to experts, the increasing trend of MI in the young is a disturbing phenomenon with devastating consequences causes a greater impact on patient’s psychology, ability to work and socio-economic burden.

Who are at a greater risk of MI?

  • Higher Prevalence of Smoking
  • Family History of premature CHD
  • Male counterparts < 45 years of age
  • Diabetes
  • Stress
  • Hypertension

Obesity: Particularly truncal obesity due to a sedentary lifestyle, unhealthy dietary patterns and lack of physical activity counters the protection offered by a young age.

However, we are now diagnosing more and more patients with hypertension, dyslipidemia, and diabetes for the first time after they present to us with MI at a young age. To escalate matters further, ignorance of CHD combined with a false sense of security prevents younger individuals from seeking early medical advice. Hence early recognition and risk factor modification in this population are of key importance.

Other factors that need attention:

A number of other potential but uncommon causes in young MI patients which deserve attention include:

  • Cocaine abuse
  • Kawasaki disease
  • Aortoarterits, spontaneous coronary artery dissection
  • Hyperhomocysteinemia
  • Low levels of oestrogen and oral contraceptives usage in young women can also cause MI.

An important point to understand here is that young MI patients often lack warning symptoms like escalating chest pain, unlike their elderly counterparts. The first presentation of MI can be sudden death. The coronary angiography in the young tends to reveal less extensive disease in comparison to older counterparts.

Post MI outcome

There is a high incidence of depression post-MI in young patients and it can be as high as 50%. It often requires multiple strategies including counseling, personalized prescription, and management of co-occurring mental health conditions.

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