Up to 80% of heart disease, including heart attack and stroke, is preventable with regular screenings, control of chronic diseases and a healthy lifestyle. Adopting heart-healthy habits earlier in life is now more important than ever, as a growing number of adults are being diagnosed with heart disease before the age of 40.
Heart disease has long been considered a condition that primarily affects older adults, but Ochsner Health physicians say that perception no longer matches reality. Increasingly, they are diagnosing serious heart conditions in people in their 20s, 30s and 40s, some of whom initially appear healthy and active. Experts attribute this to a combination of genetics and lifestyle factors, underscoring the importance of early screening and empowering individuals to take an active role in their health.
That was the case for Ellen Pino, a Baton Rouge business owner, mom of three and competitive tennis player. During a routine tennis practice in October 2022, Pino felt like her heart briefly stopped, then began beating rapidly. Her Apple Watch indicated her heart rate was more than 200 beats per minute. Similar episodes began happening almost daily. Pino, then in her mid-30s, also noticed that her resting heart rate was often more than 100 beats per minute, even when she was relaxing at home.
鈥淚t didn鈥檛 make any sense. I鈥檓 active and healthy. I play tennis several times a week. I eat healthy. I don鈥檛 smoke. I rarely drink,鈥� Pino said. 鈥淚t was scary, and I knew something was wrong from the first time it happened. My chest got tight, and it literally took my breath away; then my heart was suddenly pounding very hard. It was a very distinct feeling.鈥�
After several months of the episodes, Pino connected with Pavan Malur, MD, a cardiologist at Ochsner Medical Complex 鈥� The Grove. Dr. Malur immediately placed Pino on a 24/7 heart monitor, which confirmed his suspicions that same day. Pino was diagnosed with supraventricular tachycardia (SVT), a rhythm disorder. If left untreated, SVT weakens the heart over time, especially with frequent or prolonged episodes, potentially leading to heart failure, stroke, or, in rare cases, sudden cardiac arrest.
鈥淎n irregular heart rhythm can lead to a weakening of the heart muscle or a stroke if a blood clot develops,鈥� Dr. Malur said. 鈥淚n some people, their blood pressure drops to a very low level, which can cause them to faint. That can be dangerous if someone is driving or in another environment where passing out can cause them to be in harm鈥檚 way.鈥�
Dr. Malur said that when cardiac conditions are diagnosed, modern medications and operations can often resolve the problem. Pino was referred to Michael Bernard, MD, section head of electrophysiology at Ochsner Medical Center - New Orleans, and underwent a catheter ablation procedure to correct the misfiring areas of her heart.
鈥淚 went from having symptoms every single day to maybe every couple of weeks at the most,鈥� Pino said. 鈥淚鈥檓 still kind of shocked that all of this happened. I feel like the people at Ochsner truly saved my life. I don鈥檛 know what the repercussions would have been had I not advocated for myself and my health.鈥�
Since sharing her story with more people, Pino has referred multiple friends and acquaintances to Dr. Malur. Like her, they are often active adults in their 30s and 40s. Some have had similar concerning symptoms, while others are aware of a family history of heart disease or other risk factors.
鈥淚 think the use of smart devices also plays a role in younger people coming to us more often. Many people wear those to monitor their heart rates and other health metrics,鈥� Dr. Malur added. 鈥淟ately, a lot of patients who are diagnosed with a form of AFib notice irregularities on their watches before I see them. The devices are more accurate and reliable than even a few years ago.鈥�
While wearable technology can help people keep better track of their health on a day-to-day basis, it can鈥檛 replace wellness visits with trained physicians.
鈥淭he demographic shift is broad, but the rise is particularly noticeable in people with obesity, sedentary routines and strong family histories of early heart disease,鈥� said Samy A. Abdelghani, MD, cardiologist at John Ochsner Heart and Vascular Institute 鈥� Slidell. 鈥淭he most common pattern is earlier onset of high blood pressure, abnormal cholesterol and insulin resistance or Type 2 diabetes, often alongside weight gain, low activity levels, poor sleep and high stress.鈥�
Dr. Abdelghani said common symptoms of heart problems can include chest pain or tightness, shortness of breath, feelings of discomfort or heaviness, dizziness or fainting. Symptoms can be subtle in some individuals, which makes regular primary care visits so important.
Reshma A. Bhanushali, MD, primary care specialist at Ochsner Lafayette General Internal Medicine, said a typical appointment should include blood pressure and blood sugar measurements, as well as an accurate check of a person鈥檚 weight and body mass index (BMI). People who have experienced heart-related symptoms may be referred to a cardiologist for cardiac monitoring, an echocardiogram or tests to determine their coronary calcium score, a measure of plaque in the arteries leading to the heart, which can be an early indicator of coronary artery disease.
Increasingly, those tests reveal high blood pressure, cholesterol and blood sugar 鈥� conditions that may not have immediate symptoms, but can put a person at risk of serious future complications if left untreated.
鈥淚n practice, it is usually a combination: genetics deals the hand and lifestyle influences how it plays out. The good news is that smart lifestyle choices can meaningfully reduce a person鈥檚 risk of heart disease even when genetics are not ideal,鈥� Dr. Abdelghani said.
In particular, Dr. Abdelghani said he has seen improvement among adults who adopt an exercise routine that combines aerobic activity and strength training, eat a Mediterranean-style diet heavy in vegetables, fruit, beans, nuts, seeds and fish, maintain a healthy sleep schedule, and avoid all forms of tobacco and vaping.
鈥淓stablish routine primary care early and treat your health like a long-term investment. Know your numbers, move consistently and eat in a way you can sustain for years,鈥� he said. 鈥淚f you do a few basics well, most people can dramatically lower their lifetime risk.鈥�
Dr. Bhanushali added that patients should seek out physicians, like those at Ochsner, who will listen to their concerns and discuss their lifestyles to uncover any risk factors.
鈥淎 lot has changed to lead to this trend of heart disease at younger and younger ages,鈥� Dr. Bhanushali said. 鈥淥ur grandparents didn鈥檛 have the stress of social media. They probably walked to work, and there was a lot more physical activity in that generation without actually calling it exercise. So, our genetics cannot be changed, but our lifestyle can be.鈥�
She stressed that a heart-healthy lifestyle has long-term benefits for every organ, including important protections for brain health as people age.
鈥淪ometimes, people don鈥檛 realize how poor habits can be detrimental to their health. Those conversations are often eye-opening,鈥� she said. 鈥淭hese are young adults who have a lot of life ahead of them. The sooner we can address any problems they are having, the sooner they can get back to the things they enjoy.鈥�
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