Ranjan Das (42) was health-conscious and used to visit the gym regularly. However, he died of a heart attack
New Delhi-resident Hemvrat Choudhury had a heart attack when he was 28 though he does not smoke or drink. Now he does a heart check-up once every three months
Alok Tanwar (34) used to run 6 km a day. After his heart attack, he has slowed the pace of his life
Is it corporate stress that is responsible for the deaths of apparently healthy urban Indians at a young age?
“Stress pushes up blood pressure, which adds to the heart’s workload, but that’s not the only reason. A family history of heart disease and smoking are equally to blame for the attacks in the young, so you’ve got to stay alert to signs of trouble,” said Dr Ganesh Mani, cardiac surgeon, Indraprastha Apollo Hospitals.
“No one can say, ‘I’m fit and healthy, I can’t get an attack’, unless they have diagnostic tests giving them an all-clear.”
Experts say 10 per cent of people in the 20s have heart diseases, which, if left untreated, can lead to a heart attack.
“In India, more than 3 million people die of heart disease each year, accounting for about 30 per cent of all deaths. If we don’t start living right, the numbers will go up to 5 million deaths by 2020,” said cardiologist Srinath Reddy, president, Public Health Foundation of India.
The mistake most apparently healthy people make, says Dr Ashok Seth, chief cardiologist and chairman, Escorts Heart Institute in New Delhi, is that they do not get screened for heart disease.
This is what had happened to Ranjan Das. “We have no clue what went wrong. He returned home at about 9 pm and complained of uneasiness and severe chest pain. Rupa (his wife) called the family doctor, who advised us to rush him to the hospital,” said a relative, who did not wish to be named.
“Heart attack is the number one killer, yet people usually don’t get screened before they hit 50. And when they do, they go for a treadmill test, which detects plaques (fatty deposits) that have blocked 70 per cent of the blood vessels. New blood markers are far more sensitive (see box) and should be done before the age of 18 years,” said Dr Seth.
Until he was 34, Alok Tanwar was the poster boy of good health. He has a personal gym with a treadmill, cross trainer and an exicycle in his East of Kailash home in south Delhi.
“I ran for 6 km each day, worked out for an hour four to five times a week, and played badminton for 40 minutes at the Siri Fort Sports Complex. The only thing I didn’t do was cardiac screening, but then, I saw no need,” said Tanwar.
Young people usually have small plaques but these can rupture, often after exertion. “The rupturing forms a clot inside the vessel, which can trigger a heart attack if it blocks a major artery,” said Dr Mani.
“Luckily, such events are rare,” he added.
At highest risk are smokers who over-exert. “Since smoking makes the blood viscous and prompts clot formation, extreme weights or treadmill without proper warm-up is a bad idea. Anyone, however healthy, who opts for extreme work-outs must get a screening done, preferably including a cardiac CT scan,” said Dr Seth.
He recommends a cardiac CT-scan for young people with risk factors or a parent with diagnosed heart disease before the age of 50 years.
“It detects plaques that have progressed just 30 per cent, which are the ones that rupture and cause heart attacks in young people,” said Dr Seth.
Small plaque deposited on the inner walls of blood vessels can rupture after exertion.
“This rupturing causes a clot to form inside the vessel, suddenly blocking blood flow. If it is a major artery — like the left main coronary artery (LMCA) and left anterior descending (LAD) artery — it can trigger a heart attack,” Dr Mani said.