- A few days back, while I was having coffee with one of my colleagues, he developed sudden onset chest pain and was sweating profusely. Looking at his condition, I felt that it could have been a heart attack and I suggested the same to him, but he replied and I quote “I can’t have a heart attack: I am just 30 years old!! This is just gastric pain, I have this quite often, but somehow today it’s quite severe.”
- Still, I got an electrocardiogram (ECG) for him asap and to his surprise, he was having a major heart attack (Anterior wall MI).
The burden of the disease:
- Is it true that 30-40-year-old people can’t have or rarely have a heart attack? Let’s check the facts.
- The Partners YOUNG-MI Registry: Among 2097 consecutive young patients with myocardial infarction, 431 (20.5%) were ≤ 40 years of age.
- Conventional risk factors for coronary heart disease (heart blockage/ heart attack) include advanced age (males beyond 40 years and females beyond 50 years), diabetes mellitus, hypertension, dyslipidemia (high blood cholesterol), smoking, and family history of heart disease.
- Still, we come across a significant number of patients with heart attacks who are below 40 years of age. Personally, in my practice, the youngest patient that I have seen suffering from a heart attack was 19 years old (An adolescent working at a Dhaba smoking 30-40 bidis per day).
- The most common risk factor for heart disease in such young patients is smoking, dyslipidemia, substance abuse (particularly cocaine) and positive family history.
Understanding the disease:
- Smoking causes certain unique alterations in the structure and function of blood cholesterol (LDL- bad cholesterol) and platelets. This makes these platelets and LDL particles adhere to the wall of coronary arteries (blood vessels supplying blood to the heart) and form plaques (minor blockage), which are quite unstable and with further bouts of smoking, they rupture and form a major thrombus (blood clots) in the coronary arteries, leading to a heart attack in such young persons.
- What actually happens to the heart during a heart attack? Imagine a group of 300 people working together on a ship, who are receiving food & water regularly. If you cut off the food supply to 1/3rd of them, only 200 people would be left, who won’t be able to manage the ship optimally & it is inevitable for the ship to sink someday.
- Similarly, our heart is just a group of muscles working together to pump blood throughout the body. During a heart attack, the blood supply to one group of muscles in the heart gets blocked totally and they die (if not intervened timely), eventually leading to long-term cardiac dysfunction and heart failure.
How to prevent a heart attack?
- Ever since our childhood days, we have been thought that “ Prevention is better than cure”. Similarly, here also, we need to focus on the prevention of heart disease, as most of the risk factors leading to heart attacks are easily modifiable and preventable.
- Quit smoking and avoid all forms of tobacco consumption. Even hookah smoking and E-cigarettes have been found to be associated with cardiovascular risk.
- Stop Substance abuse- Cocaine, methamphetamines, LSD etc.
- Maintain a healthy lifestyle- ensure 30-45 mins of exercise daily (brisk walking/ jogging/ yoga).
- Adopt a healthy diet: diet should be rich in fruits, vegetables, whole wheat grains, olive oil, beans, nuts, legumes, herbs & spices. Consume fish & seafood at least twice a week. Moderate portions of poultry, eggs, cheese & yoghurt. Avoid meats & sweets as much as possible.
- Reduce your body weight by around 5-6 kgs, if you are overweight, so as to maintain your Body Mass Index (BMI) in the normal range.
- Reduce psychosocial stress and try yoga/ meditation on a regular basis.
- Keep a regular check on your blood sugar & blood pressure at least once a year.
What to do when you have a heart attack at a younger age?
- Most of the time at this young age, people usually have heart disease, in the form of a sudden heart attack.
- So, as soon as someone has sudden onset chest pain or severe constricting chest discomfort which is associated with significant sweating, call the emergency medical services and get an ECG done at the earliest. Meanwhile, sit down or lie down, take deep breaths, and try to relax as much as possible.
- If the chest discomfort is very severe, take a couple of SORBITRATE tablets and put them under your tongue.
- Consult a doctor as the earliest. Looking at the ECG, If your physician or cardiologist confirms that you have a heart attack, go ahead for a coronary angiogram and angioplasty immediately, as advised by your cardiologist.
- Because in case of a heart attack “TIME is MUSCLE”. “The longer you waste, the more heart muscle you lose.”
- It is bad enough to have a heart attack at such a young age, but the good thing is, if intervened timely, there is minimum loss of heart muscle and heart function. You can have a near-normal cardiac function and a normal life.
- The only thing that you have to ensure after having a heart attack is to make sure that you consult your cardiologist at the earliest.
- Adhere to a strict diet regime, modify your lifestyle accordingly and ensure that you take all your medications properly.
- Do not stop your medications on your own.
- You do this, and despite having a heart attack, you will have a happy & healthy heart.
Dr. Gaurav Agarwal, Consultant – Interventional Cardiologist, Narayana Multispeciality Hospital, Jessore Road, Kolkata