Srinagar- “Dil se re”, a timeless Bollywood song, reminded us that our heart is more than just a vital organ—it’s where all our deepest feelings reside. But remember, even tiny hiccups in this heart’s rhythm can have a big impact on our lives. Amidst that is a heart attack! A significant shift is seen in the demographics of heart attack patients in Kashmir with an increasing number of young individuals getting affected.
Health experts in conversation with Kashmir Observer believe that this alarming trend in the valley is seen owing to post-Covid complications, increasing substance abuse and sedentary lifestyle.
As per the clinical observations of the doctors, one in every five patients suffering from heart attack in Kashmir is below the age of 45.
Covid-19 & Heart Attacks
Heart Attack or myocardial infarction (MI) is a fatal disease where the artery carrying blood and oxygen to the heart cannot function properly because it gets blocked. Therefore, the heart muscles do not receive enough oxygen and blood which may result in permanent heart damage. The experts revealed that most often, the patients present with typical symptoms such as chest pain radiating to the arm and profuse sweating (diaphoresis). Some patients, however, exhibit atypical symptoms.
“In many cases, the patients seek advice from local medical practitioners who misinterpret the symptoms and prescribe medication for conditions like bloating, gas, or acid reflux. What ultimately happens is a weakening of the heart, leading to heart failure. These individuals typically succumb within six months. In severe cases, they may pass away within a matter of days or few hours,” Dr Showkat Hussain, Consultant Cardiologist, Government Medical College, Anantnag told Kashmir Observer.
Consider the case of tall and sturdy 33-year-old gym trainer, Asif Ahmad (name-changed) from Banihal. He was in great shape and frequently posted his workout routines, diet, and sweat-inducing weightlifting sessions on his Instagram stories.
On a typical day, exercising at his gym, he felt a stab of chest pain and dismissed it as acid reflux. Next day, when the pain came with greater intensity, he was rushed to district hospital Banihal. From there, Asif was referred to SMHS Hospital, Srinagar.
“The patient had a history of Covid-19. An angiography done on the patient revealed a blockage in the left anterior descending artery (The left anterior descending artery branches off the left coronary artery and supplies blood to the front of the left side of the heart). Subsequently, we treated him with a stent. He is doing fine now,” the doctor treating him said.
Dr Hussain said that Covid-19 was a systemic disease that affected various parts of the body and doctors are witnessing its aftermath with an increased incidence of heart attacks in young patients.
Elaborating the connection between a heart attack and Covid-19, Dr Hussain said Myocarditis or heart inflammation directly affects the muscle tissues of the heart. Coronavirus also causes inflammation of the veins and blood vessels and affects the inner surfaces of veins and arteries. It also harms the lining of the blood vessels. “All of these together restrict the flow of blood to the heart which eventually is a reason for heart failure,” he said.
The doctor explained that the steep rise in people dying unexpectedly of heart attacks is alarming.Although, there isn’t enough published data to prove whether this is a Covid-induced phenomenon. But the heart attacks in young patients have definitely increased post-Covid. “Additionally, the sedentary lifestyle, over-consumption of junk food,rampant smoking especially among young individuals contribute to these risk factors,” he said.
According to the National Health Family Survey 5, “26.6” percent of men in the age group of 15-49 smoke cigarettes in Jammu & Kashmir. “Similarly, 3.9 percent males smoke bidis while 2.4 smoke hookah,” the survey said.
Drug Abuse & Heart Attacks
The experts emphasized that in addition to smoking cigarettes, increasing substance abuse among youngsters is also a big contributing factor to heart attacks. A recent investigation report by Indian express revealed that last year, one patient walked into the valley’s largest de-addiction centre at SMHS Hospital Srinagar every 12 minutes. Police records show that the seizure of heroin — the most consumed drug in Kashmir — has more than doubled in 2022 compared to 2019.
Case in point is that of 29-year-old patient from North Kashmirwho was wheeled into the emergency ward of Government Super-speciality hospital, Srinagarlast month, clutching his chest, sweating profusely and barely conscious.
He was brought to the emergency with complaints of chest pain, cold sweating and severe generalized weakness. He had no family history of valvular or congenital heart disease. On further examination, however, it came out to be a fall out of drug overdose. The doctors tried valiantly but couldn’t resuscitate him, as he met an untimely end.
Associate Professor and Drug-Deaddiction Specialist, IMHANS, Kashmir Dr Junaid Nabi told Kashmir Observer that the most commonly used substances which can trigger heart attacks are opioids, inhalants, codeine etc. Current research studies in Kashmir state that Heroin is now the most common opioid among individuals while as injection route remains the commonest one. With increased usage of heroin in Kashmir, there has been a corresponding increase in overdose-related death.
“Drug overdose is a major cause of premature death and morbidity among heroin abusers. During a heroin overdose, there are many factors at play that contribute to ending the life of the user. As such, sudden cardiac arrest (SCA) is one of these factors,” Dr Junaid said. He noted that “Injectables” are usually responsible for cardiovascular deaths.
Dr Hussain said narcotic drugs like heroin can cause “Vasospasm”. Vasospasm refers to the sudden contraction of the muscular walls of an artery. “It causes the artery to narrow, reducing the amount of blood that can flow through it.”
Experts believe that the psycho-social stressors in our region like unemployment also contribute to factors leading to heart attacks in the young population. “With no good support system, and mounting financial distress, the young individuals often take to smoking and drugs as an escape. The overuse of social media is also one major factor. The continuous engagement on various online platforms is making the youngsters over-ambitious which eventually worsens the heart-health.”
Winter Phenomenon
Dr. Irfan Ahmad Bhat, senior cardiologist at Shri Maharaja Hari Singh (SMHS) hospital told Kashmir Observer that the people need to understand that in order to keep the body warm during winters the work of the heart doubles.
“But this is not happening in the valley only, wherever you have harsher winters, the heart attacks are more,” says Dr. Irfan.
He further said chill narrows the blood vessels and arteries of the heart as a result the blood flow is less to the heart.
“The Blood pressure also shoots-up during winters, which affects the heart,” he added.
The patients who are prone to heart attack, according to doctors are—Diabetic, Blood pressure, smokers and people above the age of 60 years.
According to officials from SMHS, the territory care hospitals witness 16 to 20 cardiac arrest cases every day, same is the case with Sher-i-Kashmir Institute of Medical Sciences (SKIMS).
Dr. Hilal Ahmad Rather, HOD Cardiology SKIMS said that they usually witness more cases of heart failure and stroke during winters.
He, however argues that there is no such research done by anyone to know why more heart attacks in winters but maintains that cold is a risk factor for heart attacks and strokes.
“Sedentary lifestyle, peculiar Dietary habits during winters might be the reason for the surge in heart blocks—the winter is the risk factor,” Dr. Rather added.
Dr. Rather added that people should take care of their diet and keep a tab on their weight.
The surge in heart attacks and other diseases amid the dip in temperature increase in number of deaths.
Diet Changes & Timely Intervention
There is no one particular definition of a healthy diet, according to the experts. In order to have a healthy heart, it is advisable to reduce consumption of junk and processed foods, adopt an active lifestyle, include a brisk walk of at least 30 minute every day, include more fruits, leafy vegetables in your diet, less salt and sugar intake and avoid food with high carbohydrates and saturated fats.
“Most importantly, the young patients who have experienced heart attacks require long-term follow-up as compared to the old patients, especially if they have received interventions such as stent placement,” Dr Hussain said.
He stressed that if the treatment in heart attack-like situations is not given on time, the chances of morbidity is more. “For example, if you wait for a long time, the pain can end, however, the heart muscle gets dead. And person a becomes disabled for a lifetime”
Early detection and immediate treatment are the key in heart attacks. “As the saying goes “Time Is Muscle,” which means the longer you wait to get someone in for treatment the more damage that can occur to the heart muscle and the less likely are the chances for recovery. Therefore, the golden hour should not be lost. In that timeframe, the heart muscle can be salvaged,” the cardiologist concluded.
Tailpiece
Not long ago, heart attacks were primarily a problem faced by older adults. It was rare for anyone younger than 40 to have a heart attack. Now 1 in 5 heart attack patients are younger than 40 years of age.
Here’s another troubling fact to highlight the problem: Having a heart attack in 20s or early 30s is more common. Between the years 2000-2016, the heart attack rate increased by 2% every year in this young age group, according to the US based ‘Cardio Metabolic Institute’.
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