Anuraj Singh is learning all about self-care these days. He loves strumming the guitar to ease himself out of a stressful situation. He never misses his nature walks and has just about begun to relish home-made food. Yet a little over a month ago, this 21-year-old BBA student collapsed after a major heart attack on the day he was planning a get-together with his friends. Sensing that the shooting back pain and the tightening of his chest was abnormal, he had the presence of mind to rush to hospital. By the time his friends managed to track him down, he had already had an angioplasty. Yet he was not into smoking, drinking or had a family history. “But I had not dealt with the grief and mental stress after my mother’s death. And over time, bottling up emotions also clogged my heart.”
He still has another clot that is expected to dissolve with medication soon. Then he will gradually scale up his physical activity as part of a cardiac rehabilitation programme. He hopes to begin with yoga and then build up endurance for heart-friendly routines. And he’s back to preparing for his CAT (Common Admission Test) exams for an MBA course. “Everyone should take preventive measures and know what BMI (body mass index), cholesterol and blood sugar mean for your heart health. And all of these risks are self-created if you do not control them in time,” he says.
How mom’s death became a trigger for a stress-induced heart attack
Studies show how high levels of stress hormones like cortisol can increase blood cholesterol, triglycerides, blood sugar and blood pressure, all common risk factors for heart disease. Stress also changes the nature of blood vessels in the coronary artery and promotes buildup of plaque deposits. According to Dr Sanjeev Gera, Director and HOD, Cardiology, at Fortis Hospital, Noida, Anuraj did not realise that his stress created risk factors for heart disease. “His mother died after a liver transplant procedure and he was a donor. Wracked by guilt at not being able to save her, he gave up on life. With erratic meals, binge-eating, sleepless nights and rarely feeling the urge to step out of his home, he gained weight to the point of obesity. Being young, he never got tested for cholesterol but the damage was done,” he says.
Dr Gera was not at all surprised by Anuraj’s deranged cholesterol levels at such a young age. He has treated over 100 patients for heart disease over the last six months, 50 per cent of whom are below 50 years of age. Now half the number of patients in this category are below 35 years of age. “I have treated almost 30 patients in the 25-30 age group,” he says.
Dr Gera feels Indians, who are genetically prone to developing symptoms of heart disease at least a decade earlier than other populations, need to track risk factors. “If you have even a few of the markers such as family history of disease, sedentary lifestyle, high cholesterol, BP and prediabetes, they can cause heart disease at any age,” he warns. Which is why a basic heart screening test should be done in the 20s, he feels. Particularly, if you are a smoker or a regular drinker. Most of Dr Gera’s patients are IT professionals who work under stress, have no fixed sleeping hours, eat out and confine their existence to a couch or chair.
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What are warning signs?
They also tend to ignore warning signals before a heart attack. “Sometimes you can have intense gas bouts a week before though people tend to ignore them,” says Dr Gera. Anuraj had been having similar complaints and some pain in his chest before his birthday on September 4. When the pain did not go away, he visited a doctor at Fortis Hospital, who prescribed some antacids and an ECG in 24 hours. On September 5, the intensity of pain had increased so much that he drove to the hospital and collapsed. The ECG report showed two clots in his heart in the left and right ventricle. He didn’t require a stent but just a balloon that opened up his clogged arteries.
So what got Anuraj into the depression trough?
For more than a year, after his mother’s death last April, he had been living alone. With no siblings and father in a transferable job, life had come to a standstill for the 21-year-old. While he had lost weight to be a fit donor for his mother before her liver transplant surgery, he stopped focussing on his body after her death. Compounding matters was the fact that he signed up for a work-from-home internship at a Noida firm. Without social interaction, he slipped deeper into depression, ordered his food from restaurants, was tied to his work station and bed and put on weight uncontrollably.
Anuraj’s biggest learning has been to take care of his mental health. His father has also sought a transfer to be with him. “Without a fit body and mind, anybody can drift,” he says as he has learnt his life lesson early and is determined to live fit and happy.
