Since the risk of a heart attack and other heart problems increases with age, it’s easy to think of these conditions as only something adults experience. Most teenagers aren’t concerned with their heart health.

However, while still uncommon, heart attacks in people under 40 years old are increasing. This means that it’s important for young people to know the risk factors of heart problems and how to keep their hearts healthy. In this article, we’ll learn what types of heart problems occur in teens, what causes them, and how they’re treated.

Types of Heart Problems in Teens

Many heart problems that occur in older adults can also occur in adolescents. However, the same heart conditions may look different in teens. Some of the most common types of heart problems that affect teens — and their symptoms — are discussed below.

Heart Attack

A heart attack is a life-threatening condition where there’s not enough blood flow to the heart muscle. They usually happen because of an abrupt clot blockage of a coronary artery (an artery that supplies the heart). Heart attacks are exceptionally rare in teens and young adults because they mostly have healthy coronary arteries. They usually occur due to an underlying condition, such as a genetic issue with the heart.

All of the heart attack symptoms that occur in adults may be present in teens as well. They may include:

• Chest pain or pressure
• Fainting (passing out) while exercising
• Shortness of breath
• Pain in the arm, neck, jaw, or belly
• Nausea and vomiting
• Skin discoloration

Sudden Cardiac Arrest

Sudden cardiac arrest is when the heart suddenly stops pumping blood due to an electrical issue. It is not the same thing as a heart attack, although a heart attack may cause it. When the heart stops beating, the affected person may faint and be unresponsive. At that point, it is crucial to save someone’s life with cardiopulmonary resuscitation (CPR) and call emergency services. If a sudden cardiac arrest causes a person to die, it may also be referred to as a sudden cardiac death.

Sudden cardiac arrest is more common in older adults. Heart attack is the most common cause of cardiac arrest in older adults, while genetic conditions including hypertrophic cardiomyopathy or arrhythmogenic cardiomyopathy are the most common causes among teens.

Cardiac arrest can happen to seemingly healthy people without any known cause. Sudden cardiac arrest is one of the leading causes of death in young athletes. It’s estimated that between 1 in 50,000 to 1 in 100,000 young athletes die of sudden cardiac arrest each year. It’s important that young athletes have regular health checkups for sudden cardiac arrest prevention.

Heart Failure

Heart failure happens when a weak or damaged heart can’t pump enough blood to meet the body’s needs. Heart failure usually occurs in children and teens for different reasons than in adults. In adults, the most common causes of heart failure are coronary artery disease, heart attack, high blood pressure, heart valve dysfunction, and diabetes. In children and teens, heart failure is usually due to congenital heart defects (heart defects a person is born with) that affect how well the heart functions.

Symptoms of heart failure in teens may include:

• Unusual tiredness
• Frequent urination at night
• Decreased appetite
• Cough and shortness of breath
• Irregular heartbeat
• Swollen feet and ankles
• Weight gain

Arrhythmia

An arrhythmia is a condition that causes an irregular heartbeat that might be too slow, too fast, or skip a beat. In most cases, arrhythmia in children and teens is not harmful. Dangerous arrhythmias in children and teens are usually caused by an inherited condition, such as long QT syndrome or catecholaminergic polymorphic ventricular tachycardia, which might cause sudden cardiac death.

Arrhythmias caused by coronary heart disease in children and teens are extremely rare. Some types of arrhythmia have a good prognosis if recognized and treated properly.

Symptoms of an arrhythmia in teens may include:

• Chest pain
• Dizziness
• Fainting
• Heart palpitations (feeling of fluttering or heart pounding)
• Shortness of breath

If children or teens feel those symptoms, it’s important to tell their healthcare provider. A cardiological workup may be needed. If your doctor feels there is a high risk for sudden cardiac death, they may recommend an implantable cardioverter defibrillator. This device is implanted in the heart and uses electricity to control dangerous arrhythmia if it occurs.

What Causes a Heart Attack in Teens?

Many heart conditions in adults result from a combination of risk factors that build up throughout a person’s life. Because teenagers haven’t had their whole lives to accumulate risk factors, heart disease in teens is usually related to risk factors that can’t be changed.

Heart Disease Risk Factors

The same risk factors that increase the risk of heart disease in older adults can also affect teenagers. These include:

• High blood pressure
• High cholesterol
• Type 2 diabetes
• A body mass index (BMI) score in the overweight or obese range
• Smoking and vaping
• Lack of physical activity
• Unhealthy diet
• Drug use

Although these risk factors are more common in older adults, they are becoming more common in children and teens. About 10 percent of children and young adults between the ages of 4 and 25 have high blood pressure. Almost 20 percent of children and adolescents in the U.S. have obesity. Similarly, the number of teens with type 2 diabetes continues to increase.

Genetic Conditions

People with a family history of heart attack or heart disease may have a higher risk of the same health conditions because of genetic factors that are passed from parent to child. There are also heart conditions that are passed down genetically.

One genetic condition that increases the risk of having a heart attack in teenagers is familial hypercholesterolemia. This condition is caused by a mutation (change) in your genes that results in high levels of bad cholesterol — also known as low-density lipoprotein (LDL). High levels of LDL increase the risk of developing atherosclerosis at a younger age. In atherosclerosis, cholesterol builds up on the blood vessel walls and may eventually cause a heart attack or other heart issues.

Congenital Heart Defects

A congenital heart defect is an abnormality in the structure of the heart that’s present at birth. About 1 percent of children are born with a congenital heart defect. Most congenital heart defects are diagnosed in childhood. However, these heart problems can sometimes go unrecognized in otherwise healthy children. Without treatment, congenital heart defects can increase the risk of heart attacks, heart failure, and sudden cardiac arrest.

Infections and Inflammatory Conditions

Teens can develop heart issues as a complication of an infection or an inflammatory condition.

Rheumatic Heart Disease

Rheumatic fever can cause heart disease if inflammation damages the heart valves — the openings between the different chambers of the heart. This is called rheumatic heart disease. Rheumatic fever is caused by a common infection with the same bacteria that causes strep throat, often when a strep throat infection is not properly treated with antibiotics.

Without treatment, rheumatic heart disease can lead to heart failure. Other infections can also lead to heart problems. For example, COVID-19 has been linked to an increased risk of heart attacks in young adults.

Kawasaki Disease

Kawasaki disease is an inflammatory condition that can damage the heart muscle, leading to a heart attack or heart failure. Kawasaki disease is most common in children younger than 5. Researchers don’t know what causes Kawasaki disease, but it’s thought to occur after an infection or due to environmental factors. Teens who had Kawasaki disease as a child may continue to have an increased risk of heart attack.

Other Causes

Other health conditions and medications that can increase the risk of heart issues in teens include:

• An injury or blunt hit to the chest
• Pregnancy
• Cancer treatment
• Stimulant medications to treat attention-deficit/hyperactivity disorder (ADHD)

Talk to your healthcare provider or pediatrician to learn more about your teen’s risk factors for heart disease.

Detecting Heart Issues in Teens

All babies born in the U.S. are checked for serious congenital heart defects the day they’re born. Pediatricians will also check for common heart problems during a sports physical. However, some heart defects can go unrecognized until they cause problems later in life.

Teenagers with heart-related symptoms may need additional testing and evaluation with a pediatric cardiologist — a specialist who treats children with heart problems. The type of diagnostic testing depends on the symptoms they’re experiencing.

How Are Heart Issues in Teens Treated?

The specific treatment depends on the underlying cause of heart disease. Treatment options may include surgery, medications, and healthy lifestyle changes.

Parents can help teens lower the risk of heart attack and other heart issues by encouraging them to:

• Get plenty of exercise.
• Eat a healthy diet.
• Avoid alcohol, smoking, and drugs.
• Quickly report unusual symptoms.
• Manage underlying health problems and attend all doctor’s appointments.

You can also learn more about your family history to better understand their inherited risk factors, and share this information with your doctor.

Talk With Others Who Understand

MyHeartDiseaseTeam is the social network for people with heart disease and their loved ones. More than 62,000 members come together to ask questions, give advice, and share their stories with others who understand life with heart disease.

Have you had a heart attack as a young person? Do you know a teenager who’s had a heart attack or other heart issues? Share your experience in the comments below, or start a conversation by posting on your Activities page.