When former cricketer Sourav Ganguly, 48 years old and extremely fit, suffered a heart attack early this month, it came as a shocking reminder to many of us: That this health issue, once believed to be affecting the old people, is increasingly occurring in younger men and women. Doctors suggest taking precautions such as controlling diabetes, high blood pressure, body weight, cholesterol, undergoing regular cardiac evaluation and quitting smoking as well as exercising and consuming a balanced diet.
Asked about the possible reasons behind the surge in heart attacks among young men and women, Dr Abhinit Gupta, consultant interventional cardiology, Regency Superspeciality Hospital, Kanpur replies, “There is convenience of technology coupled with modern lifestyle, the young population has become more inactive than ever and thus there is a surge in cardiac issues among the age-group of 21-40 due to their sedentary lifestyle. Sitting for long periods is associated with worse health outcomes including heart disease, Type 2 diabetes and cancer. Poor and sedentary lifestyle, bingeing on alcohol and smoking among the younger population are some of the factors that not only add the risk for diabetes and hypertension but also affect the proper heart functioning in the long run. Apart from a person’s genetic disposition and family history which are the most common and uncontrollable risk factors, the youth are succumbing to heart ailments due to poor lifestyle, stress and erratic sleep patterns.”
Dr Gupta advises incorporating some simple lifestyle changes: consuming a healthy balanced diet, being physically active, doing regular exercise, no smoking and controlling blood cholesterol and sugar levels can prevent the occurrence of heart attacks in young individuals. These can reduce the risk of CHD, stroke and dementia and also have other health benefits.
Dr Yugal Kishore Mishra, chief of clinical services, head of cardiac sciences and chief cardiovascular surgeon, HCMCT Manipal Hospitals says, “This is the winter time and our hospital is witnessing a huge influx of cardiac patients. We are witnessing that a lot of young men and women are coming to us with heart ailments. This has been observed that it is not a sudden surge but a gradual one where young people are getting heart attacks. In my practice, I have operated several young patients, even 22-years old patients with coronary heart diseases. I have performed numerous heart bypass surgeries in adults from 20 to 50 years age group. As such in India, coronary heart disease is 10 years younger than the western counterpart because of genetics.”
Talking about the risk factors and how to mitigate them, Dr Bipeenchandra Bhamre, cardiothoracic surgeon, Sir H.N. Reliance Foundation Hospital and Research Centre, Mumbai says, “there are several risk factors for heart attack. Coronary artery disease is multifactorial. Diabetes mellitus, high blood pressure, high cholesterol, stress, smoking, lack of exercises, tobacco use, and familial heart disease. Some of the risk factors are controllable and some are uncontrollable like genetic or familial factors. The remaining risk factors are controllable like if you are using tobacco in any form like smoking, chewing, etc, by quitting tobacco you can give yourself the best gift. By quitting smoking you can reduce the risk of heart disease significantly. Similarly, if you have high blood pressure, high sugar, or cholesterol you need periodic checkups and take your medications on time. Remember heart disease has not remained the disease affecting people of over 65 years of age, it’s affecting the younger population as well. So, if you get chest pain or shortness of breath, get yourself checked by a doctor immediately.” Avoid fried and salty food. Regular exercise is the best medicine to avoid heart disease. Simple brisk walking for 40 minutes per day has shown to decrease cardiovascular disease significantly, he adds.
“We receive an average of 300-400 patients a month with heart diseases between December to February every year. However, this year, we have seen an average of 500 to 600 patients a month since November, which is nearly a 50% rise from the past years. One reason is that the temperature in Delhi and many parts of north India started dropping since November that narrows blood vessels and increases heart rate and blood pressure. The recent hike in the number of Covid-19 infected people has substantially affected their hearts, especially in people with pre-existing heart problems or other comorbidities. Doctors advise that people with heart conditions and those who have recovered from Covid-19 in the past few months need extra care to prevent any fatal heart condition during winters. Such people must take extra care of their hearts, “ points out Dr Ashish Agarwal, senior consultant and head, Department of Cardiology, Aakash Healthcare, Dwarka. He adds that they advise them to watch out for chest pain, increasing or extreme shortness of breath with exertion, swelling of the ankles, an irregular heartbeat, heart palpitations, waking up at night short of breath, not being able to lie flat without shortness of breath, or feeling lightheaded or dizzy. Dr Agarwal continues, “Depending on the patient, we advise them to undergo regular screening tests to check their heart health. Besides, standard care for the heart in winters apply, such as do regular exercise, avoid fried food and alcohol.”
“The most common heart complications after Covid infection is myocarditis, an inflammation of the heart muscle that could increase the risk of heart failure. A study published in JAMA Cardiology shows 78% of recovered patients have abnormalities in the hearts while 60% have an ‘ongoing myocardial inflammation’. It also found higher levels of troponin, the blood enzyme that is also an indicator of heart damage. Having an incurable viral infection like Covid-19 around during winters can increase the risk of heart failure or heart attack. This is because blood vessels in the body become more constricted due to exposure to extremely cold temperatures in winters that can restrict blood flow to the body and the heart,” says Dr Aseem Dhall, senior cardiologist, Indian Spinal Injuries Centre, New Delhi. Avoid venturing out in cold and if unavoidable, wear enough layers of clothes. If you are travelling to a colder area, ensure not to exert yourself too much and acclimatise well before undertaking any strenuous activity such as hiking/trekking or skiing.
On chances of heart diseases among women, Dr D.K. Jhamb, director and HOD Cardiology, Paras Hospitals, Gurugram says: According to the Centres for Disease Control and Prevention, about 1 in 30 Asian women experience heart diseases. This is also one of the leading causes of death after cancer. Some of the reasons behind heart attack in women are diabetes, stress, depression, smoking, menopause, and inflammatory diseases among others.
Diabetes: Women with diabetes are more likely to develop heart disease than men with diabetes. Also, because diabetes can change the way you feel pain, you’re at greater risk of having a silent heart attack without symptoms.
Stress and depression: They affect women more than men. Both these conditions make it difficult to maintain a healthy lifestyle, leading to heart issues.
Smoking: It blocks your arteries and makes you prone to heart attacks.
Menopause: Low levels of estrogen after menopause pose a significant risk of developing the disease in smaller blood vessels.
Inflammatory diseases. Rheumatoid arthritis, lupus and others can increase the risk of heart disease in both men and women.
Dr D.K. Jhamb points out that women also tend to have blockages not only in their main arteries but also in the smaller ones that supply blood to the heart — a condition called small vessel heart disease or coronary microvascular disease. “We have been seeing an early onset of heart attack and other cardiovascular issues in young adults. But, it becomes more prevalent in women after 45.” If young women have a family history of diabetes and heart diseases, they should get their vitals checked at a regular period.
Talking about Ischemic heart disease, Dr Bhamre asserts, “Ischemic heart disease or coronary artery disease means blockages in your blood vessels supplying oxygen to the heart muscle. Early symptoms are chest pain after walking or climbing stairs, shortness of breath after walking for a few meters. Some patients get a left shoulder or left arm pain. Some patients experience pain in the jaw, throat or upper abdomen. Pain or discomfort after eating food is also one of the symptoms. Heart symptoms start when we start exerting ourselves. So remember once you get any of the above-mentioned symptoms consult a doctor.”
EARLY SYMPTOMS OF CARDIOVASCULAR DISEASES
• Pain areas: in the area between shoulder blades, arm, chest, jaw, left arm• Pain types: can be like a clenched fist in the chest
• Pain circumstances: can occur during rest
• Whole body: impending doom, dizziness, fatigue, light-headedness, clammy skin, cold sweat, or sweating
• Gastrointestinal: heartburn, indigestion, nausea, or vomiting
• Arm: discomfort or tightness• Neck: discomfort or tightness
—By Dr Narayan Gadkar, consultant cardiologist at Zen Multispeciality Hospital, Chembur
