Hyderabad: In the last 10 days, Telangana has seen horrifying occurrences of young people collapsing on the spot and dying. These unexpected occurrences in healthy, young males in public spaces have led to an alarm.
Sudden cardiac arrest with a spot dead situation has sparked the need for right heart care approaches in young.
The cases recorded in Telangana in public domain are:
· February 20, 2023: In a haldi ceremony at Kallapathar in Hyderabad, a man fainted on the floor as he bent to apply turmeric to the groom’s feet. Rabbani, the guest suffered heart attack and was declared dead at the hospital.
· February 24, 2023: Thirty-year-old police constable Y Vishal collapsed in the gym after a warm up. Resident of Bowenpally he went for work out in the gym at East Maredpelly. He was rushed to the hospital but doctors stated that it is a sudden cardiac death.
· February 26, 2023: A 19-year-old teenager Mutyam collapsed and died while dancing at the wedding of his relative in Pardi village of Nirmal district, about 200 km from Hyderabad. He was lean, active and healthy. There was no distress as he was dancing without any huffing or puffing. He just fell down and doctors stated that it was a massive heart attack.
· February 28, 2023: A 38-year-old Shyam Yadav suffered cardiac arrest while playing badminton at Professor Jayshankar Indoor stadium in Lalapet in the evening. This was his regular routine after office hours. He fell down and was declared brought dead by doctors. A case of sudden cardiac death.
A case of timely medical help
February 24, 2023: A man lying unconscious on the road, drew the attention of traffic constable, Raja Shekhar of Rajendranagar police station. He checked on the person and conducted CPR on him. The man survived. He was later identified as Balaji. He stepped off the bus and collapsed. The timely help by Raja Shekhar has once again shown how CPR helps and it is important that public officers like traffic police, police and other emergency officials are trained which helps in saving lives in public domain.
Is sudden cardiac arrest in young new?
No, sudden cardiac arrests in the young have been observed for decades. Traditionally sudden cardiac arrests have been associated with older individuals but it is now being seen more in younger people.
Numerous studies have shown that sudden cardiac arrests can occur in people of all ages, including children and teenagers. Some studies have even suggested that sudden cardiac arrest is the leading cause of death in young athletes. In fact in a FIFA (International Federation of Association of Football) sudden death registry, there were 617 cardiac arrests in young athletes in between 2014 and 2018.
What contributes to young heart attacks?
There are a number of underlying conditions that can contribute to sudden cardiac arrest in the young:
· inherited heart conditions
· structural heart defects,and electrical abnormalities in the heart.
However, in many cases, the cause of sudden cardiac arrest in young people remains unknown.
A growing concern
Awareness of the issue has increased in recent years, and there have been calls for more research to better understand the causes of sudden cardiac arrest in young people and to develop effective screening and prevention strategies.
The recent sudden cardiac arrests in Telangana have caused significant concern among the public. One reason for the concern about sudden cardiac arrests is the high prevalence of risk factors for heart disease in the population.
These risk factors include obesity, hypertension, diabetes, and a sedentary lifestyle, all of which can contribute to the development of heart disease and increase the risk of sudden cardiac arrest.
Increased documentation of sudden deaths with the proliferation of smart phone camera recordings following online education and work-from-home culture during Covid-19 has also contributed to the increased awareness of the sudden deaths spreading panic across India.
Covid 19 and heart problems
The COVID-19 pandemic has had a significant impact on the incidence of heart disease. Several factors associated with COVID-19, such as inflammation, hypoxia, and clotting abnormalities, can contribute to an increased risk of heart disease and other cardiovascular complications.
One of the most common cardiovascular complications associated with COVID-19 is myocarditis, an inflammation of the heart muscle that can cause chest pain, shortness of breath, and other symptoms. Myocarditis can lead to arrhythmias, heart failure, and other complications, and in severe cases, it can be life-threatening.
COVID-19 can cause myocarditis, an inflammation of heart muscle. It can also increase the risk of blood clots, which can cause heart attacks and strokes. This risk is particularly high in people with underlying cardiovascular disease or other risk factors for heart disease, such as obesity, diabetes, and high blood pressure.
The stress and anxiety associated with the pandemic can also contribute to an increased risk of heart disease. Many people may be experiencing increased stress levels due to concerns about the virus, job loss, and other economic uncertainties. Stress can increase blood pressure and heart rate, which can damage the cardiovascular system over time.
Finally, the COVID-19 pandemic has disrupted healthcare services, and also preventive checks and follow ups. This along with increased unhealthy food intake, reduced exercise and increased stress coupled with the increased heart attack risk associated with Covid-19 has led to a perfect storm of conditions leading to cardiac arrests in the young.
No evidence that Covid 19 vaccine causes death
A lot of people suspect Covid-19 vaccination for these deaths, but so far, there is no credible evidence to affirm that these deaths are vaccine related. However, more studies have to be done to quell the anxiety in the public regarding these rumours.
To reduce these deaths, a multipronged approach is needed:
1. Known preventive strategies help: Healthcare providers and public health officials have emphasized the importance of maintaining a healthy lifestyle, managing risk factors for heart disease, and seeking medical attention promptly if symptoms of heart disease or other cardiovascular complications occur. This includes following a healthy diet, engaging in regular exercise, quitting smoking, and taking medications as prescribed by a healthcare provider.
2. Preventive check-ups are a must: Preventive heart check-ups are important because they can help detect potential heart problems before they become serious or life-threatening.
Regular preventive heart check-ups typically involve a physical exam, blood tests, and other diagnostic tests such as an electrocardiogram (ECG), echocardiogram and an exercise stress test (TMT). During the physical exam, your doctor will check your blood pressure, pulse, and other vital signs, as well as listen to your heart and lungs. Blood tests can help assess your cholesterol levels, blood sugar levels, and other markers of heart health.
3. Everyone must learn to do CPR: Everyone should learn CPR because it can save lives, is easy to learn, sudden cardiac death can happen to anyone, is a valuable life skill, and is a community effort. Properly done CPR saves lives as has been amply demonstrated by numerous incidences. The government of Telangana is planning to impart the training of CPR in a big way.
4. Public Access Defibrillators need to be installed: An important component of CPR, the use of automated defibrillators can be mastered by very simple training. The public should have access to these devices during the CPR. Metros like Hyderabad are very nice places to start the installation of these devices. Recently, KTR has expressed his intention to take this suggestion seriously.
5. Post mortem examination of the suddenly dead young people should be done: This not only helps the siblings of the diseased by identifying possible genetic reasons, but the community also benefits from the information.
6. No one should panic: There is a need to reduce panic about the sudden deaths that are happening because panic adds to the cardiac risk and also because the preventive strategies coupled with regular heart check-ups will reduce the risk of these deaths by more than 90%.
Doctors opinion by
- Dr. M.S.S. Mukharjee MD, DM, DNB, FESC.
Senior Interventional Cardiologist, Managing Director, Pulse Heart Center Director, Pulse Heart Charitable Trust Founder - Ex President, Indian Medical Association Kukatpally.