Silent Blockage Of Even 40% Can Cause Heart Attacks Due To Stress, Extreme Exercises: Dr Ashok Seth

As per a 2016 World Health Organisation (WHO) report, India accounts for one-fifth of the total cardiovascular-related deaths in the world, and heart attacks account for 28 per cent of all deaths in the country. The report said that 45 per cent of these deaths happen in the age group of 40 to 69 years. Whereas, in recent times and especially in the post-pandemic world, the occurrence of heart attacks and cardiac arrests have considerably grown with doctors reporting the sudden jump of these episodes. 

In an exclusive conversation with BW Healthcare World, Dr Ashok Seth, Chairman, Fortis Escorts Heart Institute stated that in India, Coronary Artery Disease (CAD) is on the rise adding that while the West has managed to curb deaths from coronary disease its numbers are going up in India.

He stated the second biggest concern that India is facing is the rise of heart diseases in the young population, with cardiac problems occurring 10-15 years earlier in India compared with the West. He believes that in the coming years the cardiovascular challenge is going to be immensely big, “The disease burden that we're going to see exactly 15 to 20 years from now it's going to overtake anything that we have actually ever seen before,” he explained.

Talking about disease processes, he said the main challenges in Cardiology today are, an increase of CAD, hypertension, and diabetes. To curb this he said that the diagnosis and treatment of diabetes and hypertension has to go downstream and technology can play a huge role in enabling this. 

“Heart disease and heart blockages can occur silently and don't need to get to 90 per cent for one to feel discomfort and then have a heart attack,  blockage as much as 40, 50 and 60 per cent, which otherwise would not create any symptoms can also cause heart attacks in situations of severe exercise and severe stress,” Dr Seth stated.

He said that the age group of 30 to 50 years is seeing these kinds of episodes more, due to either undiagnosed heart conditions or conditions which are causing symptoms like minor blockages, but also have situations of extreme stress that cause clotting of blood. Whereas very early deaths of people less than 20 years are usually due to congenital heart problems which can cause sudden cardiac death.  

“The blockages can occur from a family history, diabetes, hypertension, and especially due to heavy smoking, people may not have anything else but even if they're heavy smokers, they will suddenly form a clot in their arteries of the heart on extreme exercise. And that's one of the clear worries about a heavy smoker who actually can have a heart attack even on a 10 per cent blockage during severe exercise,” Dr Seth revealed.

He added people doing extreme exercises including suddenly getting into gyming, heavy weight lifting etc. should have at least some checkups to know and understand their risk factors. 

Covid Made Matters Worse

The Indian Council of Medical Research (ICMR) is presently investigating the correlation of heart attacks and Covid for the Indian population, the Union Health Minister, Mansukh Mandaviya announced in late March 2023 and said that ICMR will conclude the study in two months. 

A 2022 study published in the Medical Journal of Virology, looked at the mortality data of US citizens pre and post pandemic, and the results of the study revealed that post pandemic the heart attacks rose by 14 per cent. The study said that the excess in acute myocardial infarction persisted throughout the pandemic, even during the mild Omicron variant wave. 

“Covid has definitely contributed to an increased tendency for clotting of arteries of the blood to create heart attacks, heart muscle weakening, and irregular heartbeats to create arrhythmias all of which can cause or contribute to a sudden cardiac arrest,” Dr Seth said. 

He added that it's been seen in vast population studies that there's been a two and a half to three times increase of heart diseases in every person who's had Covid, “Further 30 per cent deaths in severe Covid occurred due to cardiac related problems. But even for those who had mild Covid, the tendency for increased clotting and heart attack has remained there for a period of up to a year,” Dr Seth enumerated. 

Dr Seth delineated that taking precautions in this scenario is incumbent on the people because now there is an added effect of the Covid 19 virus. Apart from Covid, he said pollution is also contributing to heart diseases, adding that the heart attacks and sudden collapses could be multifactorial. “It's multifactorial and that's why if we add on to our own risk factors, COVID and pollution, we now have an increased milieu for having heart attacks,” he added. 

Know Your Risk Factors

Dr Seth advised that everyone should be aware of their risk factors for heart diseases as much of it is in our hands and does not require vast clinical investigations. Family history of heart disease, smoking, hypertension and diabetes are some of the risk factors that everyone should keep in check for keeping their heart health healthy. 

“Just walking briskly for 45 minutes a day. 150 minutes in a whole week can decrease your chances of having heart disease or heart attack by 25 per cent because it lowers lipid and obesity. It actually gets you fitter. It controls your diabetes, it will close your hypertension and yet we are fond of bodybuilding, but not of cardiac friendly exercises,” Dr Seth added.