Hyderabad: On Wednesday, a 14-year-old was brought to a hospital in Secunderabad with a complaint of chest pain. When doctors ran an ECG on her, they were surprised to find that she appeared to have had a heart attack.
Treatment was immediately begun and a coronary angiogram was done which showed an atherosclerotic plaque rupture with thrombus. It was managed accordingly.
Her parents were equally puzzled. The girl, belonging to a family of agriculturists, was described as an active teen and someone who had scored high marks in her Class 10 exams.
Her case alarmed doctors because 14 does not fall in the normal age group when such problems are encountered.
Dr J. Shivkumar, who treated the child at Apollo Hospital, said, “It is very, very rare in teenagers, To our very surprise, she was 14 years and nine months old and thinly built.”
Deccan Chronicle spoke with Dr Shivkumar and asked him why heart attacks on the rise among young people. Excerpts:
Q. In what age groups are heart attacks generally recorded?
A. For the last several decades, ageing has been established as one of the biggest risk factors for heart attacks, typically affecting men above 50 and women over 65. Now, people in their 20s, 30s and 40s are falling victim to cardiovascular attacks.Twenty years ago, this wasn’t the case and was rarely discussed in medical schools. There’s been a shift in people’s routine – too much Uber Eats and not enough cardio. Increased screen time has dramatically impacted how much we move. Even jobs are more sedentary and require less physical activity than in past decades. These bad habits are starting in early childhood now.
Q Why do you think this is happening?
One of the biggest risk factors is the increasing incidence of Type 2 diabetes. Dietary choices such as exposure and access to ultra-processed food, sedentary lifestyle and decreased physical activity are the causes.
Q How can this be handled?
Heart experts always thought about primary and secondary prevention when it comes to heart attacks. That is, trying to prevent the first heart attack and then trying to prevent the second heart attack.
Recently, there has been a shift to the idea of primordial prevention. This means trying to prevent the progression of the heart attack risk factors. There are things we have control over such as exercising, eating nutritious food, not smoking, managing stress and blood pressure. Primordial prevention also includes education about what behaviours put you at risk for cardiovascular disease. These include obesity, poor diet and lack of exercise, Type 2 diabetes, high blood pressure, high cholesterol, smoking and a family history of cardiovascular disease.
Q Who is at risk?
Heart attacks can happen to anyone but the risk is especially high when genetics come into play. Primordial and primary prevention is crucial for those with a family history of heart disease.
The hereditary risk of heart disease is defined by having a first-degree male relative (like a father, brother or son) under the age of 55 or a first-degree female relative (like the mother, sister or daughter) under the age of 65 with a heart attack or stroke history.
Q What guidelines would you prescribe?
Guidelines recommend that people from the ages 20 to 39 without hereditary risk have their cardiovascular health assessed every four to six years. The biggest thing is prevention. At the end of the day, it’s important to understand what your risk factors are – high blood pressure, waist circumference, unhealthy BMI – and work to correct them early.
Not enough young people take their risk factors seriously, But we need to be aggressive about risk factor modification or the heart attack rate in young people is going to keep climbing.
