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No, people don’t get a heart attack because of a blocked artery

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The standard model of heart disease is just plain wrong.  Most of us don’t get a heart attack because our arteries get blocked—and that’s especially true for women.

Fewer than half of all women who suffer a heart attack (myocardial infarction) have blocked arteries, and it’s also the cause in just 70 percent of men.

Researchers from the Mayo Clinic analysed 1,474 heart attack cases that happened in Minnesota between 2003 and 2018 and discovered that fewer than 47 percent of the women had blocked arteries.

In 34 percent of the cases in the women, the attack was classified as a supply/demand mismatch secondary myocardial infarction (SSDMs), when the heart is starved of oxygen, possibly because of anaemia or an infection.

SSDM was the common culprit in women who were younger than 45, the researchers found, and the other main cause was a sudden tear in the artery wall, known as spontaneous coronary artery dissection (SCAD).

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References
JACC, 2025; 86: doi: 10.1016/j.jacc.2025.07.012
Article Topics: heart attack, Heart Health
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