Amy Josar never had trouble picking up her dog. After all, Recey, the Jack Russell-pug mix, weighed only 17 pounds. But one night in the summer of 2016, Josar just couldn’t do it. She hadn’t been feeling well for a few days, with a handful of symptoms—chest pressure she attributed to the summer’s heat, plus diarrhea, indigestion, intense sweats—that made her wonder whether she had a virus.
But it wasn’t a virus. It was a heart attack. Josar was only 37 years old.
“We have heart disease in our family, but it’s a generation removed and it affected people much older,” Josar told The Daily Beast. “I was just, like, ‘How did this happen?’”
Josar is one of about 735,000 Americans who have a heart attack every year, according to the Centers for Disease Control and Prevention. But her younger age, healthy diet, exercise plan, and lack of smoking history seemed at odds with her heart attack. If anything, her health markers showed no signs of having poor cardiovascular health: older in age, maybe with a poor diet or an obesity diagnosis, maybe someone who smoked cigarettes all their life.
But the reality is that heart disease does not discriminate: It can affect anyone. Rather, the root of the heart disease might be harder to find. Josar’s heart attack was caused by a near-fatal marriage of a blood clot—which doctors think was caused by her birth control—and Sjogren’s syndrome, an immune disorder that can increase the risk of heart attack.
John Osborne, M.D., Ph.D., a cardiologist who focuses on preventative cardiology and volunteers with the American Heart Association, says that heart disease is typically caused by risk factors that he calls The Big Four: diabetes, tobacco use, high blood pressure and cholesterol. But it’s important to remember that these aren’t the only risk factors and that poor cardiovascular health can affect even the (seemingly) healthiest of people.