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Pause for a moment and feel your heartbeat. Cardiac ailments are on the rise. A little care goes a long way in avoiding complications
World Heart Day
World Heart Day

Heart diseases are the leading cause of deaths globally, according to the World Health Organization. And India often is referred as the ‘capital’ of cardiovascular ailments, considering the fact that the prevalence rate here is two to three times higher than western countries. 

In India, Kerala is at the top when it comes to the “risk of suffering fatal or non-fatal heart attacks and other cardiovascular events”, according to a major mapping exercise carried out in 2018. About 20 of 100 people over the age of 30 are vulnerable, note experts.   

There was a time when heart diseases were viewed as an ‘old-age thing’, affecting people aged over 60. But that notion has changed. Recent deaths of Kannada superstar Puneeth Rajkumar, actor Sidharth Shukla, singer Krishnakumar Kunnath (KK) made many youngsters pause and take note of their heartbeats. 

These days, people aged between 35 and 50 are spooked by symptoms such as fatigue, palpitations and shortness of breath. They should be, say experts. 

‘Cases among people in the 20s on the rise’
Dr Jabir Abdullakutty, senior consultant and director of clinical research at Lisie Hospital in Kochi, recalls attending to a 21-year-old patient who had a heart attack recently. There was no underlying disease or signs of blood clotting. “But, he was a chain smoker,” says Dr Jabir. “In Kerala, a large number of youth suffer from heart disease due to smoking.” 

In the human body, there’s a process called atherosclerosis, where fats, cholesterol and other substances build up in and on the artery walls, he explains. “This starts from the age of 10. With smoking, the process gets accelerated,” says Dr Jabir. “So, a block that is likely to happen naturally by the age of 90 would hit one in the 20s or 30s. Nowadays, heart disease cases among people in their 20s are on the rise.” 

‘Covid-19, sudden intense workouts pose risks’  
Besides smoking, other risk factors include, sedentary activity, family history, and diabetes, which directly affects the heart blood vessels. Add to that poor food choices, high levels of stress, and unscientific workout routines. 

Doctors note an upsurge in the number of heart disease cases following the Covid outbreak. “There is an increased risk of thromboembolism (blood clotting) among people who are or have been infected. This has led to myocardial infarction (heart attack),” notes Dr Thrudeep Sagar, cardiologist at Apollo Adlux Hospital, Angamaly. 

“Also, when the lockdown restrictions were lifted, many people took up intense training programme all of a sudden. This is not good; the heart muscles get fatigued.”   

Dr Thrudeep adds “over physical exertion without proper lifestyle modification and intake of nutritious food as per medical advice” is also dangerous. 

“There have also been cases of even doctors also not following such guidelines,” he says. “A fellow-doctor, who used to run long distances earlier, restarted running two weeks after recovering from Covid.

He suffered a massive cardiac arrest.” 

Check-ups are essential before starting workouts after a long sedentary period, says Dr Thrudeep. “Many people start gymming without going for a cardiac check-up,” he notes. “Also, one should ensure the trainer is well-qualified.”

However, he adds, moderate-intensity exercise is advised for five days a week. “Thirty-minute exercise,  including walking twice a day, is ideal to start off with,” says Dr Thrudeep. “This moderate activity itself can reduce the process of atherosclerosis, thereby limiting cholesterol deposits and prevent heart attacks. 

Clots in the lungs
Pulmonary embolism or blood clots in the lungs was a common condition seen during the pandemic, says Dr Saji Subramanian, senior consultant interventional cardiologist at Samaritan Heart Institute in Ernakulam. 

“It occurs when a clot in some part of the body moves through the bloodstream and gets accumulated in the blood vessels of the lungs,” he explains. 

“In this condition, it is difficult for the heart to pump blood to the lungs. As a result, there will be right ventricular failure. I once attended to three members of a family; all of them got this condition post-Covid. Only one of them survived. We could not save the other two, including his 24-year-old twin brother.” 

‘Family history is crucial’
Dr Jabir notes Indians are genetically predisposed to have coronary heart disease when compared with westerners. “We are prone to not just heart disease hypertension and diabetes, too, can set in 10 years before the average western onset age of about 60 years,” he says. 

“Family history is crucial. The risk of genetic transmission is often ignored among youngsters. Diabetes and high cholesterol further increase the risk.” 

Stress kills
Stress and anxiety are, of course, notorious risk factors. Studies suggest high cortisol levels from long-term stress can increase the risk of hypertension. This, in turn, heightens the risk of heart trouble. Notably, this World Heart Day’s theme ‘Use Heart for Every Heart’ emphasises on psychological stress. 

‘”Stress cardiomyopathy is one condition that can be caused by intense emotional distress,” notes Dr Jabir. “In today’s competitive world, youngsters undergo a lot of stress -- job worries, career growth anxiety, performance pressure, etc.  These could lead to heart ailment.” 

Food choice
Dr Praveen S V, consultant interventional cardiologist at KIMS Health in Thiruvananthapuram, says the current generation’s shift to processed food is worrying. “Intake of sugar, salt, and fat content are on the rise,” he adds. 

“So, the risk among youngsters, too, is on the rise. Likewise higher consumption of non-veg food (mainly meat) means higher levels of trans fat. This can increase cholesterol levels, and the chances of blocks.” 

Men or women at higher risk?
Men, say studies. Till menopause, women have hormonal protection, says Dr Jabir. But therein lies a problem. 

“Women do experience symptoms but, in most cases, they would not be as grave as men,” he adds. “Women often hesitate to seek help, as they tend to have subtler symptoms. So, heart disease in women is often under-diagnosed and under-treated. There have been cases of medical practitioners, too, downplaying the symptoms.” Dr Saji points out that pregnant women are also prone to heart disease. “Cardiac issues are common during the post-lactation period, too. Also, there are chances of blood-clotting during the postpartum phase.

Symptoms to watch out for

  • Heaviness in middle of the chest
  • Jaw and hand pain while walking
  • Excessive sweating
  • Tendency to urinate frequently
  • Breathing trouble 
  • Chest pain while walking or climbing stairs

“These are the classic symptoms, but some of these would not last for a long time,” says Dr Jabir Abdullakutty, senior consultant and director of clinical research at Lisie Hospital in Kochi. “When you pause for a while from the activity you are doing, the distress is likely to get reduced. As a result, many tend to neglect it. In case of any of these symptoms, one should go for a cardio check-up.” 

Healthy plate model
A balanced plate is equal to a healthy diet, says Uma Kalyani, registered dietitian and yoga trainer, and founder of Umasnutriyoga, Thiruvananthapuram. “As per the plate model recommended by WHO, half of it should have vegetables (raw or cooked),” she explains. “A quarter of the plate should be filled with brown or red rice, or millets such as ragi.

The remaining quarter should have protein-rich items such as channa, legumes, fish, meat, and eggs.” It is important to consume two fruits daily, and ensure an intake of at least 250 to 300g of vegetables, she adds.Uma highlights that excess intake of protein could lead to heart diseases. “Youngsters tend to consume more protein to build muscles, but excess consumption is dangerous,” she says. “Non-veg protein, mainly red meat and chicken, spikes trans fat levels, which is a main culprit of heart disease. Trans fats are high in bakery items and reheated oil, too.”

Sleep is vital
Besides a healthy diet, about six to seven hours of quality sleep is crucial for the heart to function properly, notes Uma. “One has to sleep by at least 11pm,” she adds.

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