India is seeing a rising trend of sudden cardiac deaths amongst the young population and videos of people suddenly falling dead while in some action, like playing, exercising or dancing, are going viral on the internet, creating a scare in the public minds that their hearts are no longer safe. The Goan speaks to experts on the triggering reasons that are leading to such unexpected incidents
Damodar Karekar, a goldsmith from New Market in Margao died of sudden cardiac arrest in his mid-fifties. A slim, fit, healthy person, Karekar and both his children were sportspersons – the daughter – a badminton player, and son – a swimmer. Karekar was punctual in following his routine, and though his jewellery making business demanded long sitting hours, he was otherwise a socially active, swift and energetic person – a get-goer. What made him die of a heart failure is still a mystery for his family even after three years of his passing away.
Karekar is not the only example of sudden cardiac death (SCD) in his fifties, but there are a number of people even younger who have had SCDs across Goa. Irrespective of their profession, diet, exercise or habits, people are dying young. Those who never complained of any heart disease or heart pain also are seen getting heart attacks. The reason behind these deaths is largely unknown.
The shocking videos of persons playing some outdoor sport, climbing steps, singing on the stage or dancing in a marriage – but suddenly falling dead in a fraction of a second are real, and not faked. And not all of these people are elderly or senior citizens. Most are young, some in their 20s, 30s, 40s or 50s – but meeting the same fate – sudden death by an unknown cause of heart failure. This debunks the theory that maintaining a healthy schedule of physical exercises and workouts as well as indulging in sports activities can be held as a shield to save the person from getting a heart attack.
Why Sudden Cardiac Deaths (SCDs)?
“Heart failure is not synonymous with heart attacks. Heart failure is due to the heart's inability to pump blood to meet the body's exigencies for its various metabolic processes. Heart failure may be due for instance to valvular diseases and to cardiomyopathies (affection of heart muscles) sometimes of unknown origin. Sudden cardiac deaths (SCDs) are more often than not, due to blockages of the coronaries (arteries that supply blood to the heart). But they can be due to other aetiologies also,” opines Dr Francisco Colaco, noted cardiologist who runs Holy Spirit Hospital & Nursing Home in Margao.
“Covid and long Covid as well as Covid vaccines are causing much mortality triggering heart attacks. We have become aware of the other heart conditions that lead to SCDs. One of these is HCM (Hypertrophic Cardiomyopathy) that is fairly prevalent in Goans and leads to SCD even in athletes. I am researching this condition and soon intend to publish my research work for public awareness,” says Dr Colaco.
Underlying genetic heart conditions
Experts attribute the reasons of SCDs in young, fit gym-goers to undiagnosed underlying genetic heart conditions which get triggered by extreme physical exertion. High-intensity workouts, overuse of supplements/steroids, and hidden plaque ruptures can lead to fatal arrhythmias. HCM, thickened heart muscle, is a genetic issue. Apart from HCM, electrical issues (arrhythmias) can also result in sudden deaths, because they often remain silent until triggered by stress. Intense, sudden, or prolonged exercise like heavy lifting, high-intensity cardio can also stress the heart, causing plaque to rupture or inducing lethal rhythm problems. The use of anabolic steroids, pre-workout stimulants, and supplements can lead to high blood pressure, thick blood, and heart damage.
Even fit individuals may have underlying coronary artery disease or high blood pressure, compounded by stress, poor diet, and lack of adequate recovery. One must not ignore symptoms like chest pain, giddiness, fainting or dizzy head.
Can being fit stand as a guarantee against SCDs?
Is there any correlation between heart attacks and workouts? Why are fit and stronger people observed to have weaker hearts? The myth, that being fit automatically stands as a guarantee against heart attacks, is now broken. It is now observed that genetic conditions, hidden blockages and rhythm problems can be the culprit. Any fitness enthusiast must take it seriously that pushing his limits and overstraining his heart may lead to an emergency critical condition and land him in a hospital just in a few minutes.
Increased flow of youth in hospitals
“We are seeing an increasing number of young, fit individuals seeking cardiac advice after experiencing exercise-induced discomfort,” admits a hospital owner who advises that those suffering high BP should not exceed speed on the treadmill, as it may result in sudden hike in blood pressure levels, taking the situation out of control.
While doing workouts in a gym or lifting weights, if anyone feels dizzy or lightheaded, he must stop immediately. Breathlessness, chest tightness, palpitations are warning signs that the heart needs your attention. Breathlessness can be due to a narrowed heart valve. Marathon runners must undergo a cardiac clearance test. Treadmill test shows how the heart behaves under stress. Athletes have stronger hearts, yet they don’t escape heart attacks because their enlarged hearts can mask underlying genetic issues which trigger during peak physical stress.
Fitness must, but not exaggerated
So, the question youth often ask is, can exercise be detrimental to heart health. “Fitness is essential but extreme, unmonitored workouts can be risky. A healthy heart is built through balanced exercise, timely nutritious food, proper sleep and regular medical check-ups,” says Dr Manoj Hede, director of physical education and sports at G R Kare College of Law.
Dr Hede advises, “Never attempt to do any cardio exercises or playing in hot sun, if sleep is incomplete. Adequate sleep, along with eating healthy food on time, plays a crucial role in maintaining a healthy lifestyle and protecting the heart. While regular exercise is strongly advisable, it should be undertaken after proper screening and, under expert supervision, to reduce the risk of sudden cardiac deaths.”
