Sohail Ahmad Dar, a 25-year-old daily wages worker from village Pohan, District Shopian came back home from work on 17th July, had a glass of water and collapsed. He was taken to hospital in Shopian where he was declared dead of a heart attack. There are several such instances reported in the valley in the recent past. There has been a spurt in heart attacks involving young people in the Kashmir valley during this year. This has been a cause of serious concern and has been shared extensively in the print, television and web-based media. Persons in twenties and thirties, who were usually spared of this problem emanating from sudden blockade of an artery supplying the heart (Coronary Arteries) have been involved. This is the prime age of the population and families are dependent upon such people and losing them suddenly is catastrophic.

 

 

What are the possible reasons?

As per an international case controlled, global study “INTERHEART” published in 2005, nine modifiable risk factors explain 90% of heart attacks occurring in the community. These are cigarette smoking, high levels of bad cholesterol, high blood pressure, diabetes, abdominal obesity, psycho social stress, low consumption of fruits and vegetables, use of alcohol in moderation, lack of physical activity in that order.

These risk factors are prevalent in large numbers in our population in the valley and are cumulative in their effects. They act by producing damage to the lining of the coronary arteries and deposition of bad cholesterol inside the wall producing narrowing of the artery. The ultimate event is formation of a blood clot and closure of the artery. Immediately the muscle of the heart being supplied by that artery gets severely damaged. (Figure)

In a significant number of these persons no time is given for the recognition of the heart attack and sudden death follows. 50% of heart attack patients can die suddenly because of a cardiac arrest occurring due to a chaotic heart rhythm which if not instantaneously recognized leads to death within a few minutes.

Why are younger people getting sudden deaths?

The risk factors being present in a large population even at younger age is one of the most plausible reasons. The happenings during the last 2 years in the valley known to everybody lead to people staying indoors for prolonged periods due to lock downs .  These reasons were politico-administrative in the beginning but continued in the form of the COVID pandemic till very recently. Lack of physical activity, continued consumption of unhealthy diet, smoking and stress due to unemployment for those whose living was coming from business, tourism related activities and dependent on the internet which became erratic for long periods.

Winters give a spurt to these attacks due to intense cold. This leads to the arteries getting spasms and due to blockages enough blood not being available to supply the increased demands and leading to the attack which is often so sudden that the afflicted person does not get any warning symptoms. Heart attacks can occur when shovelling to clear paths after a heavy snowfall.

 

Some factors kept in hush

Many drugs, such as cocaine, heroin and various forms of amphetamine, affect the central nervous system and can alter a user's consciousness. In this regard Cocaine is a perfect heart attack drug. It comes in various forms. The powdered form of cocaine is either inhaled through the nose (snorted) and absorbed through nasal tissue, or dissolved in water and injected into the bloodstream. Crack is a form of cocaine that has been processed to make a rock crystal that can be smoked. Even so-called occasional cocaine users may have higher blood pressure, stiffer arteries and thicker heart muscle walls than non-users — all of which can cause a heart attack.

According to a report published by United Nation, Drug Control Programme (UNDCP) around 70 thousand people are drug addicts alone in the Kashmir division among whom approximately 31% are women. The youth is particularly involved in drug addiction as reported by Government Psychiatric Hospital Srinagar around 90% drug abusers belong to the age group of 17-35. This is a very concerning fact and the problems facing the community with unemployment, closure of educational institutions for prolonged periods, high handedness of the law enforcing agencies and a bleak future all provide a milieu to get into bad company and use drugs to get out of pessimism temporarily but then getting into a vicious cycle of self-destruction. 

 

Lessons learnt

Young people of the valley suffering serious heart problems like fatal heart attacks is a major challenge facing us. A very serious effort needs to be made to get into the bottom of its reasons and devise scientific methods and plans to overcome this increasing menace. It needs a joint effort by the administration, non-governmental agencies and voluntary organizations with cooperation of the public at large.