Atherosclerotic Coronary heart disease (CHD) and non-atherosclerotic CHD in
individuals less than 50 years of age is considered a “men’s case”. Undoubtedly, premenopausal
women develop atherosclerotic/non-atherosclerotic CHD relatively rarely compared
with men. This is attributed mostly to the cardioprotective role of estrogens (mainly estradiol).
Nevertheless, there are predisposing conditions, which also make young women vulnerable
to develop atherosclerotic/non-atherosclerotic CHD. Women who have classical cardiovascular
(CV) risk factors, such as hypertension, diabetes mellitus, smoking, obesity, and dyslipidaemia,
are more likely to develop cardiac events, even at a young age. Moreover, there are also other conditions that
cause acute coronary syndromes, even in the absence of coronary atheromatic plaques such as myocardial
bridge, coronary artery dissection, coronary artery spasm, coronary artery embolism and congenital anomalies
of coronary arteries. Also, autoimmune diseases, some of which are more prevalent in women can cause atherosclerotic/
non-atherosclerotic CHD. In this narrative review we have summarized some of the causes that
predispose young women to develop atherosclerotic/non-atherosclerotic CHD.