The sudden death of a 47-year-old premium fund manager while on vacation has cast a stark light on a growing and silent threat to young Indians: sudden cardiac arrest. Siddhartha Bhaiya passed away on December 31 during a holiday in New Zealand, joining the alarming statistics of such unexpected fatalities.
This tragic incident underscores a critical gap in heart health awareness. While public attention often centres on heart attacks, experts urge a broader focus on the electrical malfunctions of the heart that can lead to sudden cardiac arrest. This condition, where the heart stops due to irregular rhythms, claims an estimated four to five million lives globally each year and accounts for nearly 10% of all cardiac deaths in India, according to the European Journal of Cardiovascular Medicine.
Beyond Heart Attacks: Understanding the Silent Electrical Storm
Dr. Darshan Krishnappa, a cardiac electrophysiologist at Manipal Hospitals, Bengaluru, explains the distinction. "A heart attack caused by a blockage can lead to sudden cardiac arrest by disturbing the heart's electrical impulses. However, it can also be triggered by numerous other factors unrelated to blockages," he states.
One primary cause is ventricular fibrillation, where the heart's lower chambers contract rapidly and chaotically, preventing oxygenated blood from being pumped to the body. Other culprits include genetic heart rhythm problems (arrhythmias), changes in heart muscle thickness or enlargement, and a weakened heart muscle that cannot pump sufficient blood.
"The positive news is that many heart arrhythmias can be effectively managed with medication, significantly lowering the risk," Dr. Krishnappa adds. "Yet, public focus remains predominantly on heart attacks and general cardiology, often overlooking the specialised role of cardiac electrophysiologists in regularising heartbeats and preventing these sudden events."
Why Arrhythmias Often Go Undetected in the Young
A major challenge in prevention is the episodic nature of some arrhythmias. Symptoms like palpitations, dizziness, or chest pain may subside by the time a patient reaches the emergency room, leaving a standard Electrocardiogram (ECG) showing normal results.
Young patients frequently experience a type of arrhythmia called Paroxysmal Supraventricular Tachycardia (PSVT), where the heart rate suddenly escalates to between 100 and 250 beats per minute. Triggers for PSVT include excessive caffeine, alcohol, tobacco, stress, dehydration, intense exercise, anaemia, and hyperthyroidism.
"Since the episode blows over quickly, an ECG often fails to capture the irregular rhythm," Dr. Krishnappa notes. "This leads to misdiagnosis as anxiety or a panic attack. Left untreated over time, it weakens the heart, elevating the risk of a sudden cardiac arrest."
The Vacation Paradox: Why Cardiac Arrest Strikes During Relaxation
It is a common misconception that sudden cardiac arrest only occurs during physical strain. In reality, underlying electrical problems can surface during deep relaxation or sleep. When the body's "rest and digest" parasympathetic system activates, it can slow the heart rate and paradoxically destabilise electrical activity in susceptible individuals.
Vacations can be a perfect storm of triggers. The residual effects of stress hormones and inflammation don't vanish immediately. An abrupt change in routine—involving heavy meals, increased alcohol consumption, dehydration, poor sleep, or unaccustomed adventure activities—can disrupt the body's electrolyte balance (potassium, magnesium), sparking abnormal rhythms.
Prevention Starts with a Simple Test: The Power of an Echocardiogram
The cornerstone of prevention, according to Dr. Krishnappa, is proactive screening. Given the limitations of a standard ECG, he advises all asymptomatic adults to undergo an echocardiogram (echo) as part of a routine health check-up.
This ultrasound of the heart can detect hidden structural problems like inflammation, thickened heart muscles, or valve issues that cause dangerous arrhythmias. Most importantly, it measures the ejection fraction—the percentage of blood pumped out with each heartbeat. A normal ejection fraction ranges from 55% to 75%. A reading below 35% indicates a significantly weakened heart and a high risk of sudden cardiac arrest.
If abnormalities are spotted in the ECG or Echo, further tests like a cardiac Holter monitor (worn for 48 hours to a week), exercise stress testing, or an electrophysiology (EP) study may be recommended.
Treatment and Lifelong Prevention Strategies
Treatment typically begins with medication. For high-risk patients, an Implantable Cardioverter-Defibrillator (ICD)—a small device implanted near the collarbone—acts as a constant watchman, monitoring rhythms and delivering corrective shocks if a life-threatening arrhythmia is detected.
Ultimately, prevention is built on a foundation of lifestyle management. Dr. Krishnappa emphasises eight key strategies: managing blood sugar and blood pressure, controlling stress, ensuring quality sleep, regular exercise, maintaining a healthy weight, adopting a heart-healthy diet, and quitting smoking.
The untimely death of Siddhartha Bhaiya is a sombre reminder that heart health vigilance must extend beyond cholesterol and blockages. Listening to your heartbeat, through advanced screening and awareness of subtle symptoms, could be the key to preventing the silent, sudden cardiac arrest that claims far too many young lives.
