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Journalism of Courage
The death of 41-year-old Mr Tamil Nadu 2022, a known weightlifter and bodybuilder, after an intense workout and steam bath in the gym, due to a sudden cardiac arrest has once again questioned the link between fitness and cardiovascular health. Coming as it does among recent deaths of fitness professionals globally, it highlights the importance of a routine cardiac profiling of every young person regardless of his exercise regimen. In this case, severe dehydration seems to have become the trigger for irregular heart beats.
The nine-time champion, Yogesh, died of a sudden cardiac arrest, a condition in which the electric impulses of the heart go awry, the heart beats irregularly and then stops abruptly. This arrhythmia sends the heart into a panic mode and its ventricles or lower chambers quiver and contract in an uncoordinated manner. So the heart cannot pump oxygenated blood that your body needs.
Is the steam bath and dehydration to blame?
Preliminary reports indicate that he was dehydrated severely in the steam room after his workout which can lead to a severe electrolyte imbalance that in turn impacts electrical impulses of the heart. This is believed to have caused arrhythmia and stoppage of the heart. But dehydration and electrolyte imbalance alone cannot cause cardiac arrest unless there is an underlying heart condition. As Dr Rajiv Bhagwat, interventional cardiologist, Nanavati Max Super Speciality Hospital, Mumbai, says, “Most athletic-oriented or fitness individuals are assumed to be in good health and may not consciously do a full cardiac profile test in their 40s. So any underlying heart condition, which manifests in the middle years, may go undetected.”
The only logical link between dehydration and a heart attack is that the lack of water reduces the blood volume and makes it sticky and more prone to clotting. Lack of water thickens your blood and makes your blood vessels constrict and can strain your heart. This can then block the heart arteries and cause a heart attack.
Why hypertension could affect bodybuilders and gym addicts?
What many do not understand is that static exercises like weight lifting can cause a sudden rise in blood pressure. “Most body builders and weight lifters go through sudden swings in blood pressure. A sudden spike is followed by a sharp dip, which seems to have happened in this case where he went for an intense workout and then a sudden, rapid body cooldown. Dynamic exercises like swimming, jogging and cycling cause a more gradual rise of blood pressure,” says Dr Bhagwat. Usage of steam baths should come with its own caveats, feels Dr Sandesh Prabhu, Consultant, Cardiology and Electrophysiology, Manipal Hospital. The temperature of the steam room is maintained at 100-110 degrees Fahrenheit (about 38 to 43 degrees Celsius) with high humidity. “Nobody should be in the steam room for longer than 10 minutes. People with pre-existing heart problems or symptoms, and those with very low or very high blood pressure, should avoid using the steam rooms and not risk arrhythmias,” he adds.
Or else, he could have had clots in the lung, which may have floated up either from the legs or the heart. But this is easily salvageable if a patient reaches the hospital in time. What about physical and mental stress? Sudden cardiac arrests among the young could be a result of stress, which is called stress cardiomyopathy. Sometimes intense emotional or physical stress can lead to rapid and severe cardiac dysfunction even when you do not have obstructive coronary artery disease or even have just 30 per cent plaques. Stress impacts cardiac ion channels, which control the heart’s electrical properties, directly. “This may lead to ventricular fibrillation, arrhythmia or irregular heartbeats and trigger a sudden cardiac arrest,” adds Dr Bhagwat. Sometimes, stress can be an accumulation of risk factors like poor sleeping habits, dyslipidaemia, family history of heart attacks and smoking.
