There is one possibility which this community will flag & downvote anyone for suggesting, which is shameful; the idea should be entertained and then dismissed, if appropriate.

You may be interested to see Kaiser Permanente's recent study, suggesting that more than one in 2,000 young men are experiencing untimely heart disease with a known cause: https://www.medrxiv.org/content/10.1101/2021.12.21.21268209v...