When the heart stops suddenly

With a worrying number of young and apparently fit people succumbing to cardiac arrests, experts discuss the causes and symptoms of this medical emergency

Forty-year-old actor Siddharth Shukla, who passed away on Thursday due to a sudden cardiac arrest, was a fitness freak. Recently, Christian Eriksen, Denmark’s midfielder, suffered a heart attack and collapsed during the Euro 2020 football match against Finland in Copenhagen. He was only 29. Eriksen was lucky to receive medical attention in time to save him.

Not long ago, Yashpal Sharma, ace cricketer and one of the fittest players, died suddenly after he returned home from his morning walk. However, cricketer Kapil Dev, survived a heart attack in October last year and so did former India captain, Sourav Ganguly.

How can a fit, high-performance athlete have a heart attack? What causes sudden cardiac arrests?

Experts say, in most cases, the athletes have an underlying heart abnormality that may have been inherited or remained undiagnosed. Sometimes exercise can trigger an attack. The intensity of the exercise may make the heart particularly vulnerable to arrhythmia (abnormal heart rhythms) that can cause a lethal outcome. People can have a predisposition to abnormal heart rhythms due to genetic makeup or a sudden plaque rupture in the coronary arteries could block an artery, and, in some cases, lead to death.

“Many active athletes sometimes make the mistake of over-training and depriving themselves of much needed rest and recovery. That builds up the stress hormone levels and may be detrimental. For those leading a healthy lifestyle, the risk of sudden cardiac arrest is pretty low,” says Dr V. Rajasekhar, Senior Interventional Cardiologist & Electrophysiologist, Yashoda Hospitals. Talking of unrecognised underlying heart disease, he says “Some are genetic diseases.” These conditions can be difficult to diagnose, says Dr Rajasekhar adding, “It is worth noting that almost 50% of those who have a heart attack have had some form of warning symptoms, which were unfortunately ignored.”

“Athletes can have undiagnosed diseases of cardiac muscles — Hypertrophic cardio myopathy is one, in which heart muscle thicken and interfere in the pumping action of the heart by blocking the blood flow or interfering with the electrical functioning of the heart, leading to abnormal rhythms that can stop the heart function completely,” says Dr M Sreenivasa Rao, Senior Consultant, Cardiologist, Apollo Hospitals. “Another issue is Coronary Artery Disease, in which cholesterol gets deposited in blood vessels, narrowing them. In some persons, this cholesterol can trigger clot formation in blood vessels of the heart, causing heart attacks and sudden death. Use of recreational drugs like cocaine too can cause spasms of heart

blood vessels, precipitating

heart attacks.” According to Dr Sreenivasa, Indians are three times more prone to coronary artery disease when compared to other races. “On top of the high carbohydrate diet, smoking and consumption of junk food and carbonated drinks lead to accelerated cholesterol deposition and causes heart attacks in the young,” he says. “An active, otherwise physically fit person, may have issues like alcohol abuse smoking or substance abuse. Some even use performance enhancers and unhealthy supplements which can put them at risk,” adds Dr Rajasekhar.

INDIANS ARE SAID TO BE THREE TIMES MORE PRONE TO CORONARY ARTERY DISEASE WHEN COMPARED TO OTHER RACES. ON TOP OF THE HIGH CARBOHYDRATE DIET, SMOKING AND CONSUMPTION OF JUNK FOOD AND CARBONATED DRINKS LEAD TO ACCELERATED CHOLESTEROL DEPOSITION AND CAUSES HEART ATTACKS IN THE YOUNG.

Sometimes exercise can trigger an attack. The intensity of the exercise may make the heart particularly vulnerable to arrhythmia (abnormal heart rhythms) that can cause a lethal outcome.