Excitement can trigger silent heart attack

TNN | Oct 21, 2014, KOLKATA: A fourth of all heart attacks strike without warning and are often triggered by a sudden excitement. They are not preceded by the usual symptoms of a cardiac ailment — chest pain, breathlessness or unconsciousness. Instead, they have a silent build-up that is likely to go unnoticed.

This is what happened to the 24-year-old football fan Subhadip Sanyal who had dilated cardiomyopathy leading to a sudden heart attack at the Salt Lake Stadium during Sunday's ISL match. The youngster survived the attack, which was possibly triggered by a sudden gust of excitement following a goal, according to doctors.

While dilated cardiomyopathy is a condition in which the heart gets enlarged and fails to pump blood, sudden attacks could also be precipitated by plaque deposited inside cardiac arteries. In both conditions, there are rarely any symptoms.

"About 25% of heart attacks happen without prior indications. They are mostly caused by arhythmia, arterial blocks or by thickening of heart muscles, apart from myopathy. Patients are taken by surprise and a sudden excitement is usually the trigger. This is what seems to have happened to the young football fan. Both stress and ecstasy could impel a heart attack in such cases for they raise the demand for oxygen in the system, putting the heart under strain," cardiac surgeon Kunal Sarkar.

The most common cause of a sudden attack, however, is a blocked artery, according to cardiologists.

"Plaque inside cardiac arteries could rupture and block them. This could happen after a sudden bout of excitement or stress. Plaque deposition often happens silently without signals. So, the patient has no way of knowing that he or she is vulnerable," said Anjan Siotia, interventional cardiologist at BM Birla Heart Research Centre.

Adrenalin in blood could also be a trigger, said experts. A reason why sudden attacks usually occur early in the day. "This is the time when adrenalin secretion is high, often precipitating an attack," said Siotia.

Depending on the time taken to transfer such patients to the hospital and the quality of treatment, survival rate could vary. But in Kolkata it was as high as 95%, according to experts. "Such patients usually survive the first attack. But the quality of care and follow-up treatment are important for plaque deposition, arhythmia or myopathy are serious disorders. They could turn fatal without constant monitoring," said Siotia.

Sanyal's condition confirmed the assessment. Doctors at AMRI, Salt Lake where he is now under treatment said he was still critical.

The best way to ward off sudden heart attacks was to undergo regular check-ups, according to Sarkar.