'Feeling fit is not good enough': Dr Devi Shetty

Shetty explains the why and how of heart attacks among the young in India

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Recently, comedian Raju Srivastav, 58, died due to complications post a heart attack. In the recent times, playback singer Krishnakumar Kunnath (KK), 53, died of heart attack after a music concert. Last year, Kannada superstar Puneeth Rajkumar, 46, suffered a heart attack during a workout. The same year, television heartthrob Sidharth Shukla, 40, suffered a cardiac arrest and passed away. All of them were young, seemingly fit, flaunting their abs and broad chests. Yet, they died.

According to the World Health Organization, India accounts for at least one-fifth of the 17.9 million cardiovascular disease-related deaths globally.

In an interview, Dr Devi Shetty, cardiac surgeon, and chairman and founder of Narayana Health, explains the why and how of heart attacks among the young in India. Excerpts:

Do you agree there is a rise in the number of heart attacks among young people in comparison to the pre-Covid days?

We saw an increase in the number of patients who were coming in with blood clots in coronary arteries. It has definitely increased during the Covid period, but we do not have documentary evidence to show that Covid is responsible for a significant increase in the number of heart attacks. There is definitely a marginal increase because of the acute phase of the pandemic. We also saw young people, post Covid, develop heart irregularities, heart-related irritability and weakness. But the good thing is that most of them recovered.

How do you assess an individual's fitness?

I remember a 65-year-old man sitting in front of me with a completely damaged heart, gasping for breath, and proudly saying he never saw a doctor in his life, as if it is a badge of honour. I wanted to tell him that he is in the mess today because he did not see a doctor. There is a common misconception that educated people have―that if one is feeling fit, he or she is fit. But, the reality is how fit you feel has nothing to do with how fit you are. You can stand in front of me and say that I climbed Mount Everest three times in a month. But that does not mean you are fit.

As Indians are we more prone to developing heart disease?

We undertook the study of coronary arteries in close to 30,000 Indians and found that 1.5 per cent of Indians have coronary artery anomaly. They have no blockages, but have a coronary artery that comes from the wrong side and runs between the two major arteries, the aorta and the pulmonary artery. At the time of extreme sports, these can get compressed and the person suddenly drops dead. A tiny percentage of young Indians also have a tendency to develop coronary artery disease. It may not be very significant, but if a 35-year-old man has a five per cent blockage, which is not causing any problem, then he will have to quit smoking, control diet and exercise. If these things are done, progression of the coronary artery disease can be slowed down.

What are the chief cardiac complaints among children?

It is mainly shortness of breath and the bluish discolouration of the fingers. It is primarily a part of congenital heart disease. These are cyanotic heart diseases with heart defects at birth that reduce the amount of oxygen delivered to the body, thereby leading to the bluish discolouration. But there has not been a rise in these cases. Just that it continues to be seen.

Women usually attribute chest pain to high acidity. But is that the beginning of a heart attack?

If any adult Indian―man or woman―complains of unexplained hyperacidity, it should be taken as a problem of the heart unless proven otherwise. Also, always approach the cardiologist before approaching the gastroenterologist. It is the first indication of a serious cardiac problem that can result in fatality. In case of any nagging pain that happens above the belt, one must consider approaching the cardiologist.

At 69, how do you keep yourself going? How often do you get health check-ups?

I am into yoga now. When I was young I was into bodybuilding and martial arts. I enjoy my life and my work. I am a very happy person. I have no stress in life. Like most Indians, I never wanted to get a cardiac CT or any other test done. But my wife told me that she would not let me enter the house without the test reports and I had no choice but to get myself tested. That was a decade ago. One needs to do a CT scan only once in a lifetime. So at my age, if heart disease isn't there, it won't happen. It is very unlikely that heart disease will hit me even after the next ten years. I do the other health check-ups on a regular basis.

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