At 40, gym-goer had sudden cardiac arrest despite clean diet, no smoking and working out for 20 years: How doctors saved his life in 8 minutes and found out the reason

HOW EARLY INTERVENTION WORKED

When Mohit was brought to the hospital, he still had no pulse. He had to be given advanced CPR, electric shocks and when a pulse showed up on the monitor, was put on the ventilator. “Every minute after a sudden cardiac arrest is critical because the brain starts dying in the absence of oxygenated blood flow. Then the organs shut down one by one,” says Dr Abbas Ali Khatai, ER consultant.

Once the heartbeats stabilised, Dr Tarun Kumar, interventional cardiologist at the Medanta Moolchand Heart Centre, administered drugs to help raise blood pressure. An electrocardiogram (ECG) and bedside echocardiogram later, doctors did an angiography and found that three of his heart vessels had been blocked. “Two arteries were completely blocked. We first did an angioplasty on the artery that had been blocked recently, a minimally invasive procedure to widen blood vessels, and put a stent, a mesh bridge to hold the walls apart and prevent them from narrowing again. Once the procedure restored blood flow in the arteries, the patient was then moved to the heart ICU, where he regained consciousness. We scheduled another procedure to open up his remaining arteries later so as not to destabilise a very compromised heart and the kidneys,” says Dr Kumar.

Mohit’s recovery was impressive. Within 24 hours, he was taken off the ventilator and his blood pressure medicines were regulated. After three days, he was stable enough to go home, where he is currently following a cardiac care protocol before the procedure to open up his remaining arteries.

CAN A HEART BLOCKAGE TRIGGER SUDDEN CARDIAC ARREST?

A heart blockage in a coronary artery disrupts blood flow to the heart muscle, potentially leading to a dangerous electrical malfunction in the heart, triggering irregular heartbeats and eventual shutdown. “In Mohit’s case, the blockage triggered his cardiac arrest,” says Dr Kumar.

Most fit youngsters, according to him, overlook getting tested for their underlying heart conditions. Some conditions like thickness of the heart muscle or hypertrophic cardiomyopathy are inherited, others may be genetically predisposed to blood clotting faster and yet others may have a family history of high cholesterol. “That’s why all Indians need to get their cardiac tests done post-25 annually, especially those with a family history. And everybody should get a full cardiac workup and endurance test done before joining a gym,” says Dr Kumar.

What Mohit had ignored was the pain he felt in his left arm every time he exercised. “We found that he had been experiencing that dull pain during workouts for the past two years and had dismissed that as muscle strain. He experienced a similar kind of pain when he went to Vaishno Devi last year. But he neglected it as a result of a trek. What he thought was a muscle pull was actually an angina pain. This is the first indication of reduced blood flow to the heart. But he never consulted anybody,” says Dr Kumar. And unknown to him, he had high blood pressure. “If only he had got a checkup done, then he would not have reached this crisis point,” he adds.

Do not neglect left upper limb pain, lower jaw pain, choking or a burning sensation and excessive fatigue.

DID UNREGULATED PROTEIN POWDERS RAISE THE RISK OF BLOCKAGE?

Wife Ruby says Mohit has been an avid gym goer for the last 20 years, was fit and, therefore, had never got a cardiac check-up or evaluation done. “We never felt the need because Mohit kept to a discipline. He never ate junk food or ordered food from outside, ate healthy at home, never smoked and drank within limits only at social occasions. We never went to a restaurant more than once a month,” she says. It was only after his heart episode that tests revealed that Mohit was hypertensive, had borderline high cholesterol and fatty liver. “But none of these conditions had manifested as symptoms,” says Ruby.

However, Mohit had recently started taking herbal supplements and protein powders in the gym. “He would spend about 1.5 hours in the gym doing cardio and strength training exercises,” says Ruby. Consuming very high amounts of protein, especially from supplements, can strain the kidneys and potentially lead to dehydration, which can indirectly affect heart health.

Also, high protein, that is beyond the tolerable limits of the body, encourages plaque build-up, according to mice studies. Researchers found that mice fed on a high fat, high protein diet had not just developed plaque, the build-up was worse than in the mice that had eaten the high fat, low protein diet. Besides, this plaque was found to be “unstable,” the kind that breaks off the arterial wall easily, increasing the risk of blockages and, potentially, a heart attack.

So if you are a gym-goer, consult a doctor first even with subtle symptoms, advises Dr Kumar. “If you indulge in heavy or strenuous activity without addressing them, then it can have catastrophic effects. It can lead to a sudden heart attack and sudden cardiac arrest,” says Dr Kumar.

WHY CPR?

Dr Abbas says CPR should be taught at the community level to save lives. “The timely administration by Mohit’s gym friends helped him. Others are not as lucky. Besides, why wait for a cardiac arrest which can even lead to permanent brain damage with patients going into coma with a tube in their throat? It leads to a big strain on the family financially, emotionally and mentally,” he says.

WHAT ABOUT POST-CARDIAC REHABILITATION?

Once procedures are done, Dr Tarun says a post-cardiac arrest survivor should start walking for 10, 15 minutes and gradually increase to 20, 30 and 40 minutes over six weeks or a little more. “After that, we do a treadmill test before suggesting what he should do ahead. Physical activity does help in collateral formation, better fitness helps in better symptom control and all of this helps in controlling body weight,” says Dr Kumar.