Understanding heart attacks, in a world without Sridevi

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The first female superstar of Bollywood succumbed to a cardiac arrest on Saturday night

It is not a happy Sunday as Indian cine buffs mourn the death of the country’s first female superstar, Sridevi.

The 54-year-old actor who was on a visit to Dubai is said to have collapsed in her hotel bathroom, rushed to the hospital and was declared brought dead. The autopsy – a routine medical procedure in such cases – is still on. But initial reports suggest the actor – who had dazzled in her comeback film English Vinglish after a 15-year hiatus not just with her spectacular talent but also with how well time had treated her – had succumbed to a myocardial infarction, commonly known as a heart attack.

Between 2004 and 2012, 12 cases of heart attack traced back to botox use, were reported to the USFDA. Heart attack is a reported side-effect in 0.24% patients who have received the skin tightening medication

What is a heart attack?

Mayo Clinic defines heart attack as a condition precipitated by blockage to “the flow of blood to the heart, most often by a build-up of fat, cholesterol and other substances, which form a plaque in the arteries that feed the heart (coronary arteries). The interrupted blood flow can damage or destroy part of the heart muscle.”

What are the symptoms?

The common symptoms of a heart attack are pressure, tightness, pain, or a squeezing or aching sensation in the chest or arm, nausea, indigestion, heartburn, shortness of breath, cold sweat, fatigue and sudden dizziness.

The suddenness of Sridevi’s demise may have stunned the nation but here’s a piece of statistic. Up to a quarter of all heart attacks may come without any warning. There are interruptions to the blood flow to the heart leading up to it but they are painless, so that when the catastrophe strikes the patient has no idea what is coming. It is known as “silent ischemia”. However these episodes can be detected by ECG but often there is no reason for the person suffering from them to seek medical attention.

What are the causes of a heart attack?

The immediate cause of course is the disruption of blood supply but the risk factors include tobacco, smoking, high blood pressure, stress, diabetes, family history of blood pressure etc. Age is a risk factor too but Sridevi at 54 was actually marginally younger than the 55 years after which women are said to be at a higher risk of a cardiac arrest. For men the age is 45 years. Cosmetic procedures too can sometimes lead to a cardiac arrest.

Between 2004 and 2012, 12 cases of MI traced back to botox use was reported to the USFDA. MI is a reported side-effect in 0.24% patients who have received the skin tightening medication. Heart attacks have also been reported in older females who have lost weight, especially through the use of a drug that blocks the absorption of fat.

How to prevent heart attacks?

The usual advice is to maintain a healthy lifestyle but Sridevi is said to have done all of it – exercise, Yoga, healthy eating, the works. However this is what doctors advise. Maintain a healthy weight with a heart-healthy diet, don’t smoke, exercise regularly, manage stress and control conditions that can lead to heart attack, such as high blood pressure, high cholesterol and diabetes. And if you are already on medications, do not drop out mid-way.

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