Raju Srivastava’s experience about exercise

Soft plaques that develop in the coronary arteries can rupture and produce a big clot, which can lead to a heart attack (acute myocardial infarction). This may come without any prior warning symptoms. According to Prof. K Srinath Reddy, a cardiologist, epidemiologist, and the president of the Public Health Foundation of India, even 30% of plaques can rupture and cause the formation of a huge obstructive clot (PHFI)

Raju Srivastava, a renowned comedian, and performer had a heart attack while exercising in a gym. However, this is hardly a brand-new development. There have been numerous instances of football players collapsing in a heap while playing or even dying on a treadmill.

Recently, instances have surfaced of seemingly healthy people having a sudden heart attack while using a treadmill or engaging in another strenuous activity. Given that exercise is known to improve cardiac health and ward against heart attacks, this seems paradoxical. There are some general facts that will help to explain this apparent paradox, according to Prof. K. Srinath Reddy, a cardiologist, epidemiologist, and president of the Public Health Foundation of India. “While the specific circumstances of prior health status and intensity of exercise undertaken are likely to vary across such cases, there are some general facts that will help to explain this apparent paradox,” he says.

AWARENESS OF PLAQUE RUPTURE

Dr. Reddy offers the following explanation for these unexpected occurrences: “Heart attacks are caused by a sudden stoppage of blood flow in one of the coronary arteries that deliver blood to the heart muscle. When a coronary artery is chronically blocked by 70% or more, it can cause angina, which is chest pain that worsens with effort because the heart is working harder to pump blood through it. A heart attack (acute myocardial infarction) can, however, happen when soft plaques that develop in the coronary arteries rupture and lead to the formation of a sizable clot. There may be no preceding symptoms or warning signs before this. Even 30% of plaques have the potential to break and cause a big obstructive clot to develop.

So how do plaques develop? Plaques develop in the coronary arteries as a result of inflammation-causing substances injuring the blood vessel lining. Smoking, diabetes, bad diets, high blood pressure, stress, insufficient sleep, and recent infections all contribute to this. The plaque then grows at the site of the damage as fat from the circulating blood lodges there. If there is a sudden or significant increase in one or more of those chronic causes of inflammation, it can also rapidly prompt a plaque rupture that results in a heart attack. According to Dr. Reddy, strenuous exercise can also rupture a plaque or set off cardiac electrical abnormalities that result in cardiac arrest.

PREVIOUS MORNING SURGE

Most of these incidents take place in the morning. “A typical early-morning spike in blood pressure is common and is a function of our evolutionary biology. At that time, blood clotting propensity is also increased. Plaque instability can result in rupture and big clot formation if a person who has some underlying coronary risk factors, hasn’t slept well, is dehydrated, and engages in intensive exercise, according to Dr. Reddy.

WORKOUTS ARE NOT BAD

This is not to say that exercise is harmful to the heart. “It is crucial to identify and manage the risk factors that cause plaque to form and burst in the coronary arteries. For numerous reasons, Indians are more likely than other population groups to experience a heart attack at a younger age, according to Dr. Reddy. This calls for extra care and caution.

CARDIAC DEATHS

Sudden cardiac death with severe exercises, such as running on a treadmill or shoveling snow, can occur in the presence of known heart blockages or, more frequently, covert coronary artery disease or misdiagnosed heart artery blockage. Compared to abrupt cardiac arrest at rest, where the heart is often weak (heart failure), if a patient is recovered in such a circumstance, he or she has a better prognosis, says Dr. Suman Bhandari, Visiting Consultant, Interventional Cardiology, Fortis Escorts Heart Institute.

The heart rate and blood pressure, which are both indicators of the heart’s need for oxygen, are affected when using a treadmill at a very high speed and/or incline. In a situation when there are heart blockages, high Mets (metabolic equivalent) at faster speeds for longer periods of time can put an unnecessary strain on a damaged cardiac circulation. They can result in a heart attack, unjustified low blood pressure, or an abrupt arrhythmia. According to current recommendations, these individuals require immediate evaluation with coronary angiography and suitable revascularization, such as stenting, says Dr. Bhandari.