Heart disease is a very general term that describes just about any problem with the structure or function of the heart.

In children and teens, structural changes that form before or just after birth are the most common cause of heart problems. In rare cases, these heart problems may be so severe that they cause serious consequences, or even a heart attack.

Less than 10 percent of all heart attacks occur in people under the age of 40. But the number of younger people having heart attacks is on the rise by about 1.7 percent more each year. This is mostly due to lifestyle factors such as substance abuse, dietary choices, and lack of exercise.

This article will review how heart disease can develop in teens. We’ll look at risk factors for a heart attack or sudden cardiac arrest, and how to help adolescents improve their heart health.

Heart attacks in teenagers are extremely rare. Sudden cardiac arrest in teens is more common but still rare. Although people often use these two terms interchangeably, they don’t mean the same thing.

Heart attacks occur when blood to the heart is suddenly stopped, usually due to coronary artery disease. Your arteries become blocked, so not enough blood can make it to your heart.

Sudden cardiac arrest is when your heart stops pumping blood effectively. Blood can’t get to important organs in your body, like your brain and lungs.

Teens can experience a heart attack or cardiac arrest for many of the same reasons as adults.

But lifestyle factors tend to be a lesser cause just because they haven’t had as much time to cause damage in teens. In adults, things like smoking, a lack of exercise, high cholesterol, and other factors build up over decades to reduce heart function.

In teens and young adults, congenital, electrical, or structural problems are more often the cause. Examples of these issues include things like:

Other conditions or factors associated with heart attacks or heart disease in adolescence can include things like:

Know the terms

Heart attack: an acute condition in which something blocks blood flow to your heart. This is usually the result of coronary artery disease. It’s very rare in teens.

Heart disease: a generic term that covers a variety of chronic heart conditions. The most common form of heart disease in the United States is coronary artery disease. That’s when plaque builds up in the walls of your arteries and can block flow.

Heart failure: a chronic condition in which the heart can’t pump enough blood to your other organs. This becomes congestive heart failure when fluid builds up in your heart and other organs. Heart failure in teens is usually due to a structural problem with the heart.

Cardiac arrest: when your heart stops because of an electrical issue or physical anomaly. This is also rare in teens but occurs in some athletes and people with congenital heart problems.

The primary risk factors for heart disease and heart attack in teens include things like:

Genetics and family history may also play a part.

Blacks are more likely to have heart attacks or heart failure than other groups, and are more likely to die from heart disease, according to a 2015 study. They have higher rates of risk factors for these conditions. Disparities in healthcare access may contribute to these risk factors not being properly treated.

Asian Indians tend to develop coronary artery disease, a risk factor for heart attacks, at an earlier age than other ethnic groups, according to a 2018 study. This may be due to common dietary decisions, such as the overuse of dairy and underuse of fruits and vegetables, according to the study.

Besides heart attacks, cardiac arrest, or heart disease, many things can cause chest pain in teens. These include:

  • muscle growth or changes
  • hormone fluctuations
  • growth spurts
  • injury or trauma
  • illnesses like pneumonia
  • panic attacks

A 2021 study found that less than 10 percent of chest pain causes in children ages 13 to 18 were due to cardiac issues.

If you experience chest pain associated with a heart attack, it usually develops in the center of the chest and may come and go. Rather than a sharp pain, chest pain is usually described as a pressure or squeezing feeling.

How to recognize a heart attack

Chest pain is not the only symptom that usually appears with a heart attack. Symptoms can vary from person to person but often include things like:

  • nausea
  • shortness of breath
  • pain in other areas
  • sweating
  • lightheadedness

If you experience these symptoms with or without chest pain and worry that you may be having a heart attack, call emergency services or seek emergency care immediately.

A panic attack can sometimes seem like a heart attack. The two events share some symptoms, like sweating and shortness of breath. But there are key differences.

If your pain starts when you’re feeling anxious, you’re more likely having a panic attack. If your pain starts after some physical exertion, it could be a heart attack.

Panic attack Heart attack
sharp, stabbing pain squeezing pain
pain gets better over time pain gets worse over time with exertion
pain stays in chest pain radiates to other parts of your body
symptoms resolve in 20–30 minutes symptoms can last for several hours
racing heart rate heart rate may stay the same or increase
dizziness nausea or vomiting
shaking or trembling
tingling in hands

It’s never too early to pay attention to your heart health. Adolescents can take steps early on to prevent cardiovascular disease by knowing their family history and risk factors.

Children and young adults should also be encouraged to establish heart-healthy habits early in life to prevent heart disease. Examples of heart-healthy habits include:

Heart attacks in the teen years are rare. Heart disease in teens usually develops because of a congenital or genetic issue.

It’s not often that lifestyle choices cause heart disease to develop in adolescence. If heart disease does develop, it’s often due to factors like obesity or drug use.

Teens can take steps early to prevent heart disease and heart attacks by getting regular exercise, making balanced diet and lifestyle choices, and avoiding drugs and alcohol.

The American Academy of Pediatrics recommends screening all children, not just athletes, for risk of cardiac arrest starting when they enter middle school or junior high.