Written by Dr Palani Kannan
Recently, the sudden death of 35-year-old cricketer Imran Patel while returning to the pavilion during a match has raised questions about why young people, especially athletes or those involved in active sports and fitness, are at risk for heart disease. Despite maintaining practice and discipline. The sudden death of South Korean actor Park Min Jae, 32, added to that concern.
Let’s understand both first. A heart attack is the result of a blockage and clotting in an artery that blocks blood flow to the heart. Sudden cardiac arrest is not caused by an obstruction but by a sudden cessation of the heart’s electrical impulses. However, if a heart attack can alter the heart’s electrical impulses, it can be a trigger for sudden cardiac arrest. Heart attacks can be quickly identified by changes in the ECG (electrocardiogram). Sudden cardiac arrest doesn’t give you time, the patient collapses.
Know your triggers
1. Unrecognized genetic disorders: Genetic conditions such as hypertrophic cardiomyopathy (HCM), which thickens the heart muscle and enlarges it, may not be detected until physical exertion triggers an abnormal heart rhythm and stops the heart.
2. Acute physical stress: Because athletes work hard, overexertion during exercise or competition can raise blood pressure and heart rate to dangerous levels, potentially overwhelming the heart. Sometimes, heart rhythm abnormalities are caused by persistent and rapid heart activity. This is called athlete’s heart, where heart muscle fibers can become disorganized and the increased stress can cause irregular heartbeats in the heart’s pumping chambers, leading to sudden cardiac arrest. These changes occur as the athlete’s heart adapts to increase its ability to supply blood and oxygen to the tissues being exercised during sports.
3. Lifestyle factors such as dehydration, irregular sleep patterns and insufficient recovery time can sometimes add to the risk. Dehydration is an important but commonly neglected cause. Insufficient fluid cools the blood, so the heart works harder to pump blood. Along with electrolyte imbalances, dehydration can cause the heart’s electrical signals to become irregular, leading to arrhythmias or cardiac arrest. Thickened blood can also cause blockages in the arteries.
4. Environmental stress: Extreme heat or cold, prolonged sweating or rapid changes in body temperature can make it more difficult for the cardiovascular system to pump blood. For those with underlying conditions such as diabetes, high cholesterol, or a family history, even short-term stressors like these can dislodge plaque from the arteries, causing blood clots that can grow in an attempt to repair torn artery walls. Large enough to stop blood flow and trigger a heart attack.
• Mental stress: Emotional stress, often seen in competitive sports or in situations of performance anxiety, can cause an adrenaline rush that stresses the heart.
Prevent cardiac episodes
I recommend echocardiograms and regular cardiac evaluations, proper hydration and electrolyte balance, proper rest and recovery after intense exercise, monitoring and managing stress levels. Control co-morbidities like hypertension and diabetes, quit smoking, eat a balanced diet and exercise.
(Dr. Palani Kannan Consultant Interventional Cardiologist, Apollo Spectra Hospital, Chennai)