Sudden cardiac arrest: How polluted air is raising risk of cardiac deaths
Air pollution is one of the factors that can increase risk of cardiac death as the inhalation of toxic particles could cause atherosclerosis, plaque formation that can lead to heart attack.
The spike in cases of sudden cardiac arrest in the country has put spotlight on the possible reasons behind deteriorating heart health of people. From sedentary lifestyle, wrong eating habits to post Covid heart damage, there are a variety of factors that are causing sudden cardiac deaths. Air pollution is another factor that can increase risk of cardiac death as the inhalation of toxic particles leads to damage to the lungs and triggers a series of biochemical and hormonal changes that cause increased atherosclerosis, plaque formation that can lead to heart attack. According to a Lancet study, short-term increases in concentrations of PM2·5 and PM10 have been associated with acute myocardial infarction, stroke, and death due to cardiovascular disease. (Also read: Air pollution: 5 harmful effects of toxic smog on your health)
"Air pollution contributes to an estimated 6.7 million deaths per year worldwide. Ambient air pollution is the number one environmental factor for all-cause mortality. More than 90% of the world’s population is living in areas with pollution levels above the WHO recommended guidelines. Levels of pollution are rising dangerously in developing countries where most of the world’s population lives. Air pollution is associated with adverse lung conditions, Asthma and COPD and increases risk of cardiovascular diseases. In fact, half of the pollution related deaths occur due to cardiac ailments," says Dr Rajeev Rajput, Cardiologist, Apollo Hospitals, Delhi.
Dr Rajput says urban pollution is a complex cocktail of chemicals such as gases, semi-volatile liquids and particles and the inhalation of these toxic particles leads to damage to the lungs and triggers a series of biochemical and hormonal changes that can cause atherosclerosis, plaque formation leading to heart attack.
"There is excessive neuro hormonal activation that can lead to irregular heartbeats, altered conduction in the heart muscles and can lead to cardiac arrest. The harmful chemicals released can lead to arterial stiffness, increased blood pressure and increased coagulability and increased clot formation," he says.
A study published by AHA has found a higher risk of cardiac arrest at levels as low as 36.9 parts per billion, which is half the EPA's standard. The Landmark MESA Air study which followed 6800 people and followed them for many years confirmed a direct link between air pollution levels and increased risk of atherosclerosis leading to increased risk of heart attack.
"This may be particularly alarming for those living in Delhi, NCR region, parts of Punjab, Haryana, and UP as these regions have very high pollution levels during this time of the year. While we pay obvious attention to directly visible and immediate problems such as asthma and irritable eyes the impact on the heart is less visible and is less talked about though it is more damaging and life threatening," says Dr Rajput.
Cardiac arrest: warning signs to look out for
Often mistaken for a heart attack, cardiac arrest occurs when the heart’s electrical system has serious malfunction. People who have previously been diagnosed with a heart ailment such as heart rhythm disorder, suffered a heart attack, have a week heart or have a family history of cardiovascular diseases are the most vulnerable to a cardiac arrest.
"People with any of these problems must remain extra cautious during the smog season to minimise exposure prevent exposure," says Dr Rajput.
Here are symptoms
• Chest pain
• Heart palpitations, Rapid or irregular heartbeats
• Unexplained high-pitched whistling sound made while breathing
• Shortness of breath
• Fainting or near fainting
• Lightheadedness
What to do in case of cardiac arrest
Dr Rajput says cardiac arrest can lead to death within minutes if treatment is not started quickly within minutes. Once detected, the onlooker must immediately respond performing the following:
- Check for responsiveness
- Call for help. Tell someone around you to call for the ambulance and another to get an AED – defibrillator)
- Check for breathing
- If the person is gasping or not breathing at all start CPR. The early CPR stared by the bystander has been proven to save lives. It is very important that general public should be trained in CPR.
- Use an AED if available and continue CPR till the help arrives.
- After receiving emergency treatment, the patient needs to be rushed to the hospital to receive treatment. In the hospital these patients are monitored closely and investigated to find the cause. The test outcomes assist the doctors in advising a long-term therapy strategy.
Treatment for sudden cardiac arrest
"Angioplasty with stenting or surgery may be necessary in some patients to restore blood flow to the heart. An implantable cardioverter defibrillator (ICD) may also be suggested in some patients. ICDs are tiny devices that are implanted usually below the collar bones and have the capability to diagnose life threatening arrhythmias and treat them by giving shock therapy. These devices have been shown to save lives as most of these patients die before reaching the hospital. The implantation process is minor and require short hospital stay. The devices require regular monitoring but with advanced technology remoter monitoring is possible," says Dr Rajput.
With the rising cases of sudden cardiac arrest across the country, the more everyone knows about the condition, the more prepared they will be to handle an emergency.