As news reports of CEO of popular Greek yogurt brand Epigamia, Rohan Mirchandani, dying of sudden cardiac arrest spread, a lot of corporates expressed concerns about whether stress was a trigger that needs looking at given the growing number of young deaths. Truth is all Indians should get their heart condition and functioning checked rather early in life as we are genetically more prone to developing heart disease. And given our high co-morbidity burden, like diabetes, hypertension and obesity, we should make a serious attempt to keep these in range.
First and foremost, sudden cardiac arrest, which is a sudden shutdown of the heart’s electrical impulses, cannot be restricted to a certain age group. Everybody in every age can develop it if there are underlying conditions for it. Let’s first distinguish it from a heart attack. A heart attack is the result of blockages and clotting in arteries which restrict blood flow to the heart. A sudden cardiac arrest is not caused by a blockage but by various triggers which can make the heart’s electrical system go haywire, resulting in irregular heartbeats and ultimately their stoppage. This rapid pace prevents the heart from pumping blood effectively, leaving the rest of your body starved of blood supply, resulting in death. However, if a heart attack can change the heart’s electrical impulses, then it could become a trigger for a sudden cardiac arrest.
CAN HEART ATTACK TRIGGER A CARDIAC ARREST?
Overall, almost 80 per cent of sudden cardiac arrest cases in people over 40 stems from coronary artery disease. Sometimes even minor blockages can cause a severe heart attack. By this I mean blockages less than 70 per cent, which do not show up in conventional tests like the treadmill test (TMT). They produce a minor blockage or plaque. But sometimes, during strenuous exercise, the covering of the plaque breaks and gets dislodged. The blood flowing over the top of the torn plaque clots to close the tear, causing a big blockage in the artery that can result in a heart attack. Now an untreated or unprepared heart, which was used to less than 70 per cent of heart blockage, may trigger wild changes in heartbeats, which can trigger a sudden cardiac arrest.
OTHER REASONS FOR SUDDEN CARDIAC ARREST IN THE YOUNG
However, for the younger population, say less than 35 years, undetected congenital heart defects or genetic abnormalities in the heart’s electrical system, usually characterised by irregular heartbeats or arrhythmia, are to blame. Hypertrophic Cardiomyopathy (HCM) is a genetic condition that thickens and enlarges the heart muscle but may not be detected until physical exertion and extreme activities trigger abnormal heart rhythms and shut down the heart. Dehydration can thicken the blood, and the heart has to work harder to pump blood. Electrolyte imbalance, usually caused by insufficient potassium or calcium — both of which help blood vessels contract and expand — can interfere with the heart’s electrical signals. Mental stress, as in work anxiety, can cause an adrenaline rush that stresses out the heart, interfering with heartbeats.
TREATMENT AND PREVENTION
Unfortunately, sudden cardiac arrest gives you a window of a few minutes within which the patient has to be administered cardio-pulmonary resuscitation (CPR) and needs a defibrillator. Compared to the US, where 85 per cent of the population knows how to do CPR, in India, only one per cent people know about it. Also we need defibrillators in public places.
For prevention, an electrocardiogram measures the electrical activity of the heart and is good enough to detect arrhythmia. It can show changes in the heartbeat that increase the risk of sudden death.
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