Australia cricket legend Shane Warne died of a suspected heart attack in Thailand on Friday, aged 52. According to a statement released by the late cricketer’s manager, he was found unresponsive in his villa and “despite the best efforts of medical staff, he could not be revived.”
With his untimely death, the topic of sudden cardiac death in super-fit young athletes is being widely discussed again. We spoke to a few doctors to know the possible causes of heart attacks in athletes. Here is what they say:
Even exercise is good only in moderation
“We all believe that running marathons and getting a six-pack abs is good for our health. However, as with everything else, even exercise is good only in moderation,” says Dr Kaushal Chhatrapati, Interventional Cardiologist, Wockhardt Hospitals, Mumbai Central.
He explains, “Strenuous exercise can cause ‘oxygen debt’ in the cardiac tissue, which can trigger cardiac arrhythmia and death. Also, increase in heart rate and BP with overzealous exercise can cause microscopic tears in our heart arteries, which are nidus for clot formation. This clot can then occlude one of our major heart arteries and cause a life-threatening heart attack.”
Unaccustomed exercise might lead to heart damage
Dr Ankur Phatarpekar, acknowledges that heart attack and sudden cardiac death are affecting people across the age group.
“In a heart attack, the blood flow to the heart is stopped which acutely damages the heart. There is a rise in cardiovascular diseases across the globe due to sedentary lifestyle and other risk factors such as hypertension, diabetes etc. Exercise is good for your health, but unaccustomed exercise might lead to heart damage and rhythm disorders. Consumption of alcohol, smoking, habit forming drugs could lead to a heart attack.”
Two main reasons for cardiac arrest in athletes
Dr. G Ramesh, points out two main risk factors for sudden cardiac death or cardiac arrest in athletes. He says:
1) Young adults with an arrhythmic substrate or predisposition to having abnormal heart rhythms because of genetic predisposition as has happened recently with an international footballer . The diagnostic tests in these cases include an ECG echo and stress test, but many cases might be missed. The treatment will be an insertion of implantable cardiac defibrillator and avoiding predisposing factors such as extreme exertion
2) The other cases are that of recent examples of our cricketers who have had a heart attack which has been treated in time as with Sourav Ganguly or Kapil Dev or proved fatal with Yashpal Sharma. The reason in these cases is a sudden plaque rupture in the coronary arteries leading to sudden blockade of the artery and sometimes sudden cardiac death.
This plaque rupture generally happens in arteries with cholesterol deposition. The reasons could be multifactorial, including family history of heart disease diabetes, hypertension, obesity, smoking, or excess alcohol consumption, extreme stress either physical or mental and dietary habits.
Everyone including athletes should go for regular cardiac checks
Accoprding to Dr. Ramesh, the best way to prevent this condition would be to have a balanced lifestyle along with regular health check-ups, including an ECG echo and stress test. In addition, control of risk factors such as diabetes and hypertension are a must. Many athletes sometimes do extreme exertion which is not advised. Everyone including athletes should go for regular cardiac checks to detect the issues which are many times asymyomatic.
“Young people have a lot of stress – stress of performance, stress associated with urbanization, lifestyle – which often leads to smoking (both active and passive smoking), drinking, unhealthy eating habits and patterns. This in turn causes stress on the heart, leading to either heart attack, cardiac arrest or arrhythmia,” he adds.
Dr. G. Ramesh summarizes, “A moderation in exercise is a key factor; ideally 45mins to 1 hour exercise is recommended 5 to 6 days in a week to maintain a good cardiac health.”
Dr Kaushal Chhatrapati,
Wockhardt Hospitals, Mumbai Central.