· Heart attack is being increasingly seen in patients as young as 20 years
· Coronary artery diseaseoccurs a decade earlier in Indian patients than in the West
· Sudden cardiac arrest is an important major cause of cardiovascular death
New Delhi, 3 October, 2016: Heart specialists in the country are all increasingly worried about what they call the ‘Deadly 3Ss: smoking, Stress, and Sedentary lifestyle’, as younger and younger people are succumbing to heart disease including heart attack and sudden cardiac arrest.
“Although most people wrongly believe that heart attack and sudden cardiac arrest are the same, these two are different entities though linked to each other by similar risk factors and causes. Heart attack occurs due to a sudden formation of a clot in an artery supplying blood to the heart resulting in muscle damage. Cardiac arrest indicates sudden cessation (stopping) of heart function and occurs usually due to an unstable very rapid heart rhythm,” explains Dr Kartikeya Bhargava, Senior Consultant Cardiac Electrophysiologist at Medanta-The Medicity. Heart attack is possibly the commonest cause of sudden cardiac arrest. However, the latter can also occur without heart attack in those with prior heart attack or other structural or electrical heart disease.
The underlying cause of heart attack is disease of the arteries, when blood supply is hampered due to hardened or narrowed arteries. It is known as coronary artery disease (CAD) and occurs due to a multitude of causes including smoking, unhealthy diet and lifestyle, sedentary habits, lack of exercise, high cholesterol and obesity. CAD in Indians is often more severe, and occurs a decade earlier than in the West. More and more young patients with CAD and heart attack, as low as of 20 years of age, are being seen by cardiologists in recent years, notes Dr Bhargava.
The treatment of heart attack involves rapid recognition and diagnosis followed by opening the occluded coronary artery by drugs or angioplasty to save damage to heart muscle. On the other hand, sudden cardiac arrest due to rapid fast abnormal rhythm needs urgent (within 3-4 minutes) delivery of a shock by a defibrillator and cardio-pulmonary resuscitation (CPR).
In India, lack of awareness about sudden cardiac arrest, lack of CPR training to laypeople, poor emergency transport facilities and delay in reaching hospital emergency after a cardiac arrest result in a very dismal outcome after out of hospital cardiac arrest. In India, sudden cardiac death accounts for 10.3% of total mortality. For patients with known heart disease with a high risk of sudden cardiac arrest, use of implantable defibrillator devices can reduce their risk and prevent loss of productive years. A cardiologist or electrophysiologist will be the best judge of what modality of treatment is required.
Since heart attack and CAD are the commonest causes of sudden cardiac arrest, the prevention and treatment of risk factors of CAD can go a long way in prevention of sudden cardiac arrest as well.
“My sincere advice to every single person on this World Heart Day is to quit smoking, perform regular exercise and eat healthy. There are smoking cessation centers today that can aid people to quit smoking using many means if they unable to do so themselves. Regular exercise in any form, of which brisk walking is the simplest, is essential for anyone to remain healthy and maintain a normal body weight. New research suggests that it’s not just about walking for 30 minutes—one needs to be active through the day. Hence, taking a 5-minute “walking break” every hour of sedentary work can help in achieving the desired minimum 10,000 steps a day as per the recommendations of the American Heart Association,” says Dr Bhargava. Also, maintaining a balance between family life and work and eliminating stress by modalities like yoga and meditation can be highly useful.
As an avid runner and yoga enthusiast himself, Dr Bhargava suggests that these practices of yoga, meditation and regular exercise should be incorporated into one’s lifestyle from early childhood itself and should become part of the school curriculum. Then, only one can achieve a good level of overall health in the general community.
Finally, if a person has any symptoms suggestive of heart disease like palpitation or breathlessness, or chest discomfort it is best to get checked by a doctor. Regular, periodic check-ups along with lifestyle modification is essential for anyone with known heart disease.
On the occasion of World Heart Day, the universal message this year is ‘Power your life’. The idea is to power the heart, because the heart powers the whole body.