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Emerging Concern Among Young People With COVID-19: Preventing Sudden Cardiac Arrest

For decades, cardiovascular diseases were considered problems related to elderly people. However, in recent years, the occurrence of heart attacks and sudden cardiac arrest are seen to be on the rise, especially among the young cohort below the age of 40. Attributed to genetics clubbed with a sedentary lifestyle, erratic sleep patterns, stress, smoking, overweight, diabetes and high blood pressure and cholesterol, the Indian youth is now increasingly falling prey to heart ailments. Almost 9000 people die due to heart ailments in the country and out of them, 900 are below 40 years. Statistics reveal that on average, the Indian population gets a heart attack eight to 10 years earlier than people in other parts of the world. Now, the second wave of COVID-19 has added to the threat of the ever-increasing cardiovascular disease burden in the country. As per the Indian government, during the 2020 wave, 31 percent of people affected with COVID-19 were under the age of 30 years whereas the percentage climbed to 32 in the second wave. Additionally, the country has reported a growth in heart problems among the young population with COVID-19, varying from sudden cardiac death to minor abnormalities in the heart rate.

The observed pattern reveals that 50 percent of heart patients first get a heart attack and 50 percent experience severe chest pain followed by a heart attack. And out of those who succumb to heart attack, 50 percent die due to sudden cardiac arrest. The rate and rhythm of the heartbeat are controlled by the heart’s electrical system and when it does not function to its full potential, sudden cardiac arrest can occur. In such a situation, if the heart rhythm does not return to normal, at times, brain damage can occur which can result in death. Hence, this World Heart Rhythm Week, let us raise awareness about symptoms and the importance of timely treatment of conditions like sudden cardiac arrest.

Delving deeper into sudden cardiac arrest: causes and symptoms

Sudden cardiac arrest can also occur in active and healthy people who have no known medical conditions. For some people certain risk factors such as previous heart attack, coronary artery disease, diabetes, heart failure, abnormal heart rhythm and low ejection fraction act as triggers. Signs of sudden cardiac arrest that a person should be wary of include collapse, chest pain or discomfort, heart palpitations, rapid or irregular heartbeats, unexplained wheezing, shortness of breath, fainting or near fainting and lightheadedness or dizziness. On experiencing such symptoms, it is imperative to visit a doctor who would recommend tests such as electrocardiogram, blood tests and imaging tests like chest x-ray, echocardiogram, nuclear scan, .coronary catheterization.

Cardiac Care in India has witnessed a paradigm shift through technologies like subcutaneous implantable cardioverter-defibrillator (S-ICD). It negates the risks associated with conventional ICD and benefits younger patients, particularly those who are more prone to the complication of intravascular or within a blood vessel or blood vascular system lead. What makes cardiologists confide in the therapy is the fact that the 2017 American Heart Association (AHA), the American College of Cardiology (ACC) and the Heart Rhythm Society (HRS) recommend the use of S-ICD for the prevention of sudden cardiac death and patients with ventricular arrhythmias.

Treating sudden cardiac arrest with minimally invasive techniques

The procedure detects abnormal heartbeats and delivers electrical pulses too restore normal ones whenever the need arises. During the procedures, the doctor implants a defibrillator subcutaneously or beneath the skin and the battery is adjusted under the armpit. The entire process can be carried remotely. On the top of the breastbone near the heart, the electrode is placed that delivers an electric shock when it detects an abnormal heart arrhythmia. The most significant benefit of implantable defibrillators is that they provide a treatment response in less than 30 seconds, increasing the chances of survival. the procedures used beneath the skin-electrode due to which the leads are not connected directly to the heart muscle.

The advantages of S-ICD include it is an alternative for children or elders who are not suitable for transvenous ICD and eliminates the risk of vascular injury as the procedure is carried without touching the heart or blood vessels. Such minimally invasive procedures leave no scarring, reduce hospital stays and give patients a better quality of life.

Even when today, we are endowed with the latest and advanced heart care technologies, making certain lifestyle changes, and trying home-based remedies can go a long way in keeping a person’s heart healthy. This becomes even more critical at a time when we are staying indoors to fight the pandemic. One should be vigilant of signs that indicate any heart-related problem, quit smoking, drink alcohol in moderation, stay physically active by exercising regularly, drink adequate amount of water, manage stress to keep blood pressure level under control and follow a diet prescribed by a dietician. Moreover, stay connected with your doctor through telemedicine to stay heart healthy.

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Dr Sridhara G

Guest Author The author is MD, DM, Consultant Cardiologist & Cardiac Electrophysicist, Department of Cardiology, Manipal Hospitals

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