Surviving a heart attack: ‘I can walk 10 km without getting tired, something that I could not even do in my 20s’

These three represent the growing number of Indians who are getting a heart attack or developing a condition at a young age. But the bigger story is their realisation of how and why they had gone wrong, their determination to work on themselves and be fitter than ever before and their ability to reclaim their life through a course correction and a cardiac rehabilitation programme. “Once the problem has been attended to and you have been put on medicines, longevity is normal, provided you stick to lifestyle corrections religiously. And if you raise endurance levels in a supervised manner, you can have an active life,” says Dr Sunil Dwivedi, Consultant, Cardiology, Manipal Hospital, Bengaluru, who has been monitoring Rajeev. “Younger patients mostly have a blockage in one artery and their heart pumping is mostly okay. The pumping mechanism of the heart depends on how long the blockage has been sitting in the artery and damaged the heart muscle. That’s the reason why younger patients can recover faster. About one-third of our patients are under 45,” says Dr Abhishek Srivastava, Director, Centre for Physical Medicine and Rehabilitation Consultant, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai.

SNEHA: I THOUGHT I HAD A GASTRIC ISSUE

Sneha didn’t experience any signs of an impending heart attack that was caused by her poor lifestyle choices. “Looking back, I think I got tired very easily. But I rationalised it as a consequence of my topsy turvy lifestyle. I was overweight at 90 kg (now I am 59 kg), was a smoker and as a PR consultant kept odd hours, with no fixed meal times, eating mostly outside the home, binging, sleeping late, waking up early and rushing to work with a grab-and-go fast food. There was no room for exercise as I had to stay ahead in a fiercely competitive workspace. But I had no idea that one of my arteries was clogging up with cholesterol and even on the day of the attack, I went to Kokilaben Hospital, which was near my office, thinking I had a severe gastric issue because of my irregular eating habits. I certainly wasn’t prepared when they told me I had had a heart attack,” says Sneha, who had a positive environment at both the hospital and home to come to terms with her condition. “My doctors and my family were the reason that I could muster the will of going ahead rather than moping on ‘why me,’ and ‘will it end so soon,’ ” she adds.

Cardiologists removed her blood clot through thrombosuction, where a catheter is inserted to suck the offending clot out. She didn’t need a stent as her arteries held good but she was in ICU for six days, was put on blood thinners and cholesterol-busting medication. “When I came out of hospital, I decided to end my pre-heart attack life for good. I took up a less demanding job, became a content writer. I wake up at 7 am, have soaked almonds and walnuts at 7.30 am, work out at the gym for an hour, get ready for work, have breakfast at 9 am, lunch at 1 pm and dinner by 8 pm. I sleep by 11 pm, come what may. I have only home-cooked food. I do calorie and carb counting, have given up smoking and drinking. And I don’t give myself a cheat day. It’s like cheating myself and my body,” says Sneha.

She does an hour of exercise six days a week with alternate days of cardio and weight training. “There’s no limit to the amount of weight I can pick up now and I can walk 10 km without getting tired, something that I could not even do in my 20s,” she says.

Dr Srivastava hand-held Sneha through her cardiac rehabilitation. “Every facility these days has a three-phase programme. There’s a heart health class, where patients are educated about heart disease, risk factors and lifestyle modifications. Then there is a graded exercise programme. For angioplasty cases, we start after three days, for multiple blockages, we begin after a week to 10 days and for a complex heart surgery, we begin after four weeks. The patient has to come to hospital thrice a week for four to six weeks, where they undergo a supervised exercise programme. They begin with an exercise tolerance test, where they walk six minutes on the treadmill with continuous ECG, blood pressure and heart rate monitoring. This we build up over the next few days and then repeat the exercise tolerance test. Then we go to the next level and about 12 to 20 sessions later, we repeat the test. If the patients have reached their heart endurance capacity and the parameters are fine, they can exercise at the gym within prescribed time limits. For example, they should not cycle beyond 15 minutes or push extra minutes on the treadmill. Besides, they have to come to the hospital once a week for three months for follow-up evaluation. This is how we build up cardio endurance. Everybody’s level of activity depends on the heart functionality. Anybody with 20 per cent functionality cannot be put at par with a 75 per cent efficiency,” he says.

Sneha also had help from a nutritionist to guide her on spreading out her meals and a psychologist to pull her out of her depressive troughs. “It’s a holistic lifestyle correction. Now I make room to indulge in my passion for travelling, go for treks and kayaking. I got married last year and the two of us are discovering the joys of adventure sports,” says Sneha.

RAJEEV: CHOLESTEROL AND LIFESTYLE WERE MY TRIGGERS

Rajeev, an IT professional from Bengaluru, had no BP or diabetes. But what he overlooked was his family history of cholesterol and related cardiac issues. He needed three stents in three arteries. “What I didn’t do was have a cholesterol check in my 30s, knowing my family history. I complicated that with my lifestyle issues, with no physical activity, long work hours, erratic eating and binging on all kinds of meat.” He has just about been allowed 10 minutes of daily walk and hopes to push it up to half-hour to 40 minutes over the next four weeks. Meanwhile, he has reduced carbs and is making the switchover to plant foods, surprised that they too can have a rich flavour profile. Dr Dwivedi says that Rajeev had developed unstable plaques as his body was prone to rapid cholesterol formation. “Sometimes, these may not be big enough to block arteries but the slightest stress in the body ruptures them, and the blood immediately clots over the tear, making it bigger than it was. Rajeev cannot let go of his physical activity ever. Some of my younger patients have gone back to playing football and hockey as before,” he adds.

SAURABH: MY VIRAL INFECTION AND HYPERTENSION TURNED DEADLY

While Sneha and Rajeev had a poor lifestyle, 32-year-old Saurabh Amlani was as fit as one could get. A biker, who compiled his own motorcycle diaries, he was into extreme feats, like riding solo between Siliguri and Varanasi for 18 hours. But unlike the other two survivors, this consultant architect and teacher had high blood pressure and diabetes. He was taken aback when he was detected with dilated cardiomyopathy after he rushed to the OPD of HN Reliance Foundation Hospital, Mumbai, following wild palpitations in October 2021. In this, the left ventricle or the heart’s main pumping chamber is enlarged and as it gets bigger, its muscular wall stretches, becoming thinner and weaker. This affects the heart’s ability to pump enough oxygen-rich blood to the rest of the body. The consistent high blood pressure had stressed the heart out further. “Doctors told me a viral infection was the last straw on the camel’s back and had affected my heart vessels and walls. My heart functionality was so low that my heart had to be transplanted and I filled up the form at the OPD itself,” says Saurabh.

Saurabh, 32, is living on a donor heart and is thinking of resuming biking and building a platform for those seeking a heart transplant

He got a donor on June 14, 2022 and had a transplant a day after. “My body became too weak to bear its own load after the procedure. So, after 10 days of ICU, I was in home isolation for six months to avoid infection and rejection of my organ. But through tele-consults, I started activity one-and-a-half months after returning home. I regained strength slowly and within four months of rehab therapy, could cycle on a home bike for 20 to 30 minutes, wearing a cardiac belt, so that both my doctor and me could monitor readings. I had Covid too during this phase but could get out with no major damage as I followed my routines to a T. After six months, I could resume my normal activity rhythms as before and even ride to the hospital for follow-ups. My heart biopsy has been normal and I am no longer breathless,” says Saurabh as he wants to hit the road again, open a backpackers’ hostel and having done 1,50,000 km, is looking to go up to Zanskar. In between, he wants to build a platform for those seeking heart transplants as “life is always worth a shot.”