5 Causes of Heart Failure in Young People, According to Experts – If you’re under the impression that heart failure is something that only affects older adults, we have some important intel to share: Heart failure—a chronic condition where the heart becomes unable to sufficiently pump enough blood to meet the body’s needs, causing symptoms like shortness of breath, heart palpitations, swelling in the extremities, and fatigue, among others—can occur in people of all ages, even children. It is estimated that more than 6.2 million people aged 20 years and older in the United States are living with heart failure. While the condition is definitely more common in people 65 and older, research shows that heart-failure-related deaths in young adults aged 16 to 44 actually increased from 2012 to 2019.1
Heart failure may occur at a younger age for a number of reasons, such as inherited heart disease or problems with the heart’s rhythm. Other factors, including a family history of heart failure, the foods you eat, substance use, some viral infections, and certain chronic health conditions can all increase your risk for developing heart failure, no matter your age.
Here are five of the most common causes of heart failure in young people.
1. Congenital heart disease
If someone has congenital heart disease, it means they were born with a problem with their heart’s structure. Thanks to advances in medicine and surgery, people with congenital heart disease can live long, fulfilling lives.2 But having a heart defect from birth can put you at a higher risk of heart failure throughout your lifetime, since stress and damage to the organ can start earlier than in someone born with a totally healthy heart.3
“Heart failure accounts for about 40% of all deaths in people with congenital heart disease,” William H. Marshall, MD, an adult congenital heart disease fellow at the Ohio State University Wexner Medical Center, tells SELF.4 That doesn’t mean everyone with congenital heart disease will experience heart failure, though: Some cases of congenital heart disease are so minor they don’t even require treatment—just regular check-ins with a cardiologist to make sure the condition doesn’t progress or worsen, according to the American Heart Association (AHA).
But some of the more severe forms of congenital heart disease can cause heart failure. In fact, among adults with complex forms of congenital heart disease, heart failure is the most common complication.3 “Therefore, lifelong follow-up with a cardiologist who specializes in the care of people with congenital heart disease is important,” Dr. Marshall says.
2. Genetic or familial cardiomyopathy
“Genetic or familial cardiomyopathy is an inherited disease that is characterized by an enlarged, weak, or thickened heart and may result in heart failure at a young age,” Tanya P. Doctorian, MD, a heart failure and transplant specialist at Loma Linda University International Heart Institute, tells SELF. There are multiple forms of cardiomyopathy, which causes the heart muscle to become thicker, stiffer, or larger, ultimately making it harder for it to pump blood throughout the body. Over time, this may lead to heart failure.
There are also multiple types of familial cardiomyopathies—hypertrophic cardiomyopathy is the most common and affects somewhere around 1 in 500 adults in the United States.5 Cardiomyopathy symptoms can include shortness of breath, fatigue, and an irregular heartbeat, among others. They often appear in mid-adulthood, but they can happen earlier too.
Experts have pinpointed some of the genes connected with familial cardiomyopathy, but others are still being researched. To prevent people from going undiagnosed and progressing to heart failure, the American College of Cardiology recommends any first-degree relative of a person with hypertrophic cardiomyopathy be screened starting at age 12.
“We’re making more diagnoses of genetic cardiomyopathy because of the easy ability to obtain genetic screening for family members with it,” Marc Goldschmidt, MD, director of the Heart Failure and Cardiomyopathy Center at the Stony Brook Heart Institute, tells SELF. This means doctors can catch—and treat—heart failure, or damage to the heart that could lead to heart failure, earlier.
3. Peripartum cardiomyopathy
Peripartum cardiomyopathy is a rare form of cardiomyopathy that occurs sometime within the last month of pregnancy and the first five months after giving birth, according to the AHA. When someone develops the condition, the heart becomes weak and enlarged. It doesn’t pump blood as well as it should and can lead to heart failure.
Peripartum cardiomyopathy can be tricky to diagnose because many of its symptoms, like fatigue and swollen ankles, mimic typical pregnancy symptoms.6 The underlying cause is also unclear, the AHA notes. Many people recover completely from it, while others experience lasting complications.
“While somewhere between 50% and 80% of people’s hearts completely recover, many continue to have impaired heart function and are at risk for worsening heart failure,” Dr. Marshall says. Some people who experience peripartum cardiomyopathy are also at an increased risk of experiencing the condition again in other pregnancies. Dr. Doctorian notes that the safety of a subsequent pregnancy depends primarily upon whether the heart function has fully recovered or not beforehand.
4. Substance use
“Among young people coming to the hospital with heart failure, I commonly see substance use as the cause—especially heavy alcohol or methamphetamine use,” Dr. Doctorian says.7 Other illicit drugs like cocaine can also impact the heart muscle and lead to heart failure with continued use.8 The way substance use contributes to heart failure is a bit different depending on the type of substance.
Heavy alcohol consumption, such as frequent binge drinking or drinking about six or more drinks each day for five years or more, can lead to alcohol-induced cardiomyopathy, where the heart becomes enlarged. This can weaken the heart muscle, impact its ability to pump blood, and potentially contribute to heart failure and other serious problems. Some people may recover from alcohol-induced cardiomyopathy by fully abstaining, but others may need to take medication or even have surgery to repair heart valves or insert a pacemaker or another type of implantable device, according to the Cleveland Clinic.
Meanwhile, methamphetamine use can cause various forms of heart damage, including inflammation, heart muscle scarring, coronary artery disease, and damage to the heart muscle cells, which can then lead to heart failure. Typically, the longer someone uses, the more damage their heart will sustain, Dr. Doctorian says. Prolonged methamphetamine use has been associated with a severe form of dilated cardiomyopathy, where the heart muscle becomes weak and can’t pump blood as effectively.9 Research shows that people who use methamphetamine experience heart disease at increased intensity and younger ages than is typical among the population at large.9
An arrhythmia is an abnormal heart rhythm. According to the AHA, it can cause the heartbeat to be too slow, too fast, or even erratic, where the heart feels like it’s fluttering or skipping a beat. While some arrhythmias are considered harmless and may not need to be treated, others can have a significant impact on the heart’s ability to fill up with blood and pump it to the rest of the body, the AHA says. When this disruption to the heart’s rhythm is left untreated, eventually heart failure and other cardiac problems can occur, according to the National Heart, Lung, and Blood Institute.
“The rhythm of the heart may become too fast, and because the heart is beating fast all the time, eventually the cardiac muscle tires and becomes dysfunctional, and then heart failure can happen,” Lourdes Prieto, MD, the director of the division of cardiology at Nicklaus Children’s Hospital in Miami, tells SELF.
“We can see arrhythmia in babies, but it can also be seen in young adults and 40- and 50-year-olds,” Dr. Prieto notes, adding that an arrhythmia is more likely to lead to heart failure in people who have additional underlying structural heart problems, like congenital heart disease or cardiomyopathy. Luckily, most arrhythmias can be managed with medication and lifestyle modifications, ultimately reducing your risk for heart failure and other cardiac issues now and as you get older.
If you have a family history or medical condition that predisposes you to heart failure at an early age, that doesn’t mean it’s absolutely going to happen to you. Talk to your doctor about how regular screening, lifestyle changes, and treatment (if it’s appropriate) can help you keep tabs on your ticker and make sure it’s in it for the long haul.
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