BENGALURU: Recent research has revealed that 20 per cent of heart attacks occur in individuals aged 45 years or younger and this number has been rising by 2 per cent every year over the last decade. Renowned consultant interventional cardiologist and electrophysiologist at Apollo Hospitals, Bannerghatta Road, Dr Abhijit V Kulkarni talks about why seemingly fit people are dying of heart attacks and also the urgency to become fit causing such deaths. He speaks on how it is no longer ‘one size fits all’ kind of situation and says every exercise regimen and lifestyle has to be customised.
Is there really an increase in youngsters dying due to heart attacks?
Celebrities dying due to heart attacks is only the tip of the iceberg. We are definitely seeing an increase in youngsters dying due to heart attacks. Earlier, it was older people getting affected, but my youngest patient is just 19 years old. In my practice, I am seeing an increase in patients aged 35-50 years dying due to heart attacks. There is sudden change in the overall symptomatology and seemingly normal people are coming with heart attacks some salvable, some not.
Is there a difference between cardiac arrest and heart attack?
Heart attacks and cardiac arrest are two different phenomena. We see a lot of heart attacks among the young as their arteries are not accustomed to blockages. Cardiac arrests are caused by either ventricular tachycardia or ventricular fibrillation in the lower chamber of the heart. Tachycardia is when the heart beat goes beyond the normal heart rate while fibrillation is when the heart starts quivering and does not pump blood out from the heart. Heart attacks, on the other hand, are due to blockages in the blood circulation while cardiac arrests are more “electrical in nature”. Irregularities in the beating of the heart, called as arrhythmias, are the reason for sudden cardiac arrests.
Why are these deaths happening in people who exercise and are seemingly fit?
Exercise and healthy lifestyle are needed and they surely provide protection against diseases. There is no denying the fact that we need to exercise and be active, but the key here possibly is moderation. Post Covid, many people seem to be in a hurry to get fit. Stressing oneself can actually become a problem. Pushing the limits is not advisable. The brain sometimes has the capacity to drive you, but the body cannot support it. Vigorous exertion leads to rupture of the blockage in the blood vessels, leading to clot formation, which leads to an abnormal heart rhythm known as ventricular fibrillation, and ultimately death.
What are the precautions youngsters can take?
The thumb rule should be to get a medical check done first, know your body and how much you can stretch yourself. Hit the gym only after this understanding. Many youngsters follow a work hard-party hard mantra, which involves sleeping late and waking up early to hit the gym. In the absence of adequate sleep (six to eight hours), the body undergoes certain hormonal changes — an excess of stress hormones is produced, which accumulate in the body. After a period of sedentary activity, getting too charged up the next day and hitting a treadmill may not be a good idea.
Even if your body is trained, muscles may be capable, but if you are dehydrated or blood has thickened due to some other illness, then you are only seeing the mechanical part of cardiac activity. But it doesn’t work like that. To mimic your favourite personality/sports figure/actor, you need not build muscles like them. There is no one-size-fits-all scenario anymore. Life has to be tailor-made. Also, anabolic steroids and muscle-building drugs that boost metabolism, can definitely provoke heart attacks, though there are not many studies. So they are best avoided. Stress is again something that can’t be quantified. Though it is not an objective parameter, it surely adds to becoming a factor for heart attacks. So keeping one’s mental health fit through Yoga, meditation, etc., is the key.
Are there any precautions that gyms must take?
All these centres must have facilities where even if some sort of incidents like these happen, they should be able to retrieve the person. These places must have an automated external defibrillator (AED). The AEDs are portable easy-to-use life-saving devices that can be used to shock a person’s heart back into rhythm if it has stopped or is beating irregularly. Most gyms and public places in western countries have this. When granting licence, or when someone is certified as a trainer, he should know how to do CPR or use AEDs to revive a person.
What role does Covid-19 play in such attacks?
Covid-19 is definitely making an impact. During the course of infection, there’s acute inflammation of the blood vessels and the blood clots, which result in heart issues. The risk of heart ailments, we feel, is higher for Covid-19 patients because of the added level of inflammation in the body and stress the heart faces in such critical times.
What are the warning signs one should watch out for during exercises?
Heaviness, chest pain, breathing difficulties, unusual sweating, dizziness, light-headedness, and heart rhythm abnormalities are some of the red flags. Most typical symptoms are attributed to their recent activities and ignored. That should not be done.
What are the routine tests to be done?
Cardiac tests should include risk factor testing for diabetes, hypertension, obesity, family history of cardiac-related ailments, etc.