Myocardial infarction: KK’s sudden demise puts focus on alarming heart ailment

Bollywood singer KK’s death, purportedly from a heart attack (myocardial infarction in medical terms) at 53 has shocked the nation. He had complained of uneasiness during a performance in Kolkata but still finished the show. A majority of Indians are unaware that they are hypertensive and prone to strokes. As a result, it is of paramount importance to know about the warning signs, symptoms, and the preventive treatments.

WHAT HAPPENS DURING A MYOCARDIAL INFARCTION?

Myocardial infarction, commonly called a heart attack, occurs when blood flow to a portion of the heart muscles (myocardium) in the middle layer of the heart wall is partially or completely cut off. These heart muscles keep the heart pumping blood to the rest of the body. When the coronary artery supplying oxygen-rich blood to the heart muscles is obstructed, the supply of oxygenated blood is cut and prolonged deprivation of this blood flow can result in cell death or damage to the heart muscles.

Interventional cardiologist Dr Sameer Dani told The Indian Express that the most common reason behind this was arterial occlusion or blockage of the artery.

When a child is born, the arteries are smooth and elastic, thus causing good blood flow. Over time, small depositions of cholesterol occur on the inner surface. The rate of this deposition depends on several factors but the major triggers are age, health conditions, and co-morbidities such as cholesterol, diabetes, high blood pressure, tobacco use or smoking, stress, genetics, and a sedentary lifestyle, Dr Dani said. The continuous cholesterol deposition in the arterial walls causes a crack to appear in the inner lining of the heart muscle, resulting in a blood clot. The moment the clot obstructs the artery, it causes a sudden heart attack.

Though the causative process is gradual, the heart attack itself occurs suddenly, Dr Dani said. Heart attacks manifest through bodily discomfort such as chest pain or discomfort that can radiate out to the neck, shoulder, jaw, or arm.

FAMILY HISTORY AND RISK OF HEART ATTACK

Individuals with a family history of heart attacks can significantly reduce the risks if they take care of the other risk factors such as controlling diabetes and cholesterol levels, giving up smoking, maintaining an active lifestyle, and having a balanced diet that contains liberal amounts of fruits and vegetables, Dr Dani told The Indian Express.

Yet, an individual’s predisposition to a heart attack will never have better odds compared to someone with no risk factor and no family history.

With limited knowledge on specific hereditary genetic predisposition, Dr Dani recommends that individuals with a family history must start early with periodic check-ups and begin taking care of the other risk factors from a young age.

ARE ALL HEART ATTACKS MYOCARDIAL INFARCTIONS?

Dr Dani said while all heart attacks were basically myocardial infarctions but there were some other sub-sets.

One of the sub-sets is a sudden cardiac death or sudden cardiac arrest. Sudden cardiac arrest occurs 80-90% of the time due to a heart attack. However, in about 15-20% of the cases, it occurs without a heart attack or heart function stoppage, explaining the death of some athletes. This occurs because the heart suddenly becomes irregular in pumping blood — either because the muscles have become thick and need more supply or there is electrical instability in some part of the muscles. As a result, despite good blood supply, there is some fault in the electrical conduction in the muscles, Dr Dani said.

Dr Dani cited the example of Danish footballer Christian Eriksen, who suffered a cardiac arrest on the field during a Euro Cup match last year — the phenomenon was similar to the overheating of a system, in layman’s terms.

Even overdose of drugs, especially cocaine, can kill a person in two ways — sudden spasms in the artery resulting in reduction of blood supply despite no arterial blockage or electrical instability resulting in either very fast or very slow heart rate, ultimately leading to a stop in activity.

SILENT HEART ATTACKS

Individuals can also suffer a “silent” heart attack, leaving it undetected at the time as there is no manifestation of the usual symptoms. These “silent” heart attacks can only be detected in the form of unusual heart activity in electrocardiograms (ECGs).

Dr Dani said such heart attacks occur when the arteries are narrowing very slowly and are more common in diabetics, but can happen to anybody.

He added that the chances of surviving after a heart attack depended on a couple of factors. If there is very large damage to the heart muscle, which is dependent on the artery that is blocked, the chances of death are quite high. On the other hand, people with an active lifestyle are more likely to survive a heart attack, he said.

PREVENTIVE CARDIOLOGY CHECKLIST

— Exercise regularly and eat fruits and vegetables

— Get a full cardiac check-up done every year as Indians are predisposed genetically to coronary artery disease

— Know and monitor blood sugar and cholesterol levels, blood pressure periodically and keep them in check

— Reduce or eliminate stress

— Cardiac imaging if an individual is in a high-risk group

The article is only for information purposes and not intended as a substitute for professional medical advice. Always seek guidance of a doctor or other qualified health professional for questions regarding health or a medical condition.