KATHMANDU, Sept 26: Biplav Singh Thakuri (name changed) is your average middle-class Nepali youth, doing his master´s degree in management and also helping his father with the family business in the border town of Birgunj.The fitness-conscious 27-year-old used to pump iron for about four years while living in Kathmandu but stopped it after returning to Birgunj last year. He still played football occasionally to ensure that he remained in shape.
Yet he had a heart attack a month ago. It never occurred to doctors in Birgunj that it was a heart attack; they thought his problem was gastritis.But when he came to Kathmandu for a follow-up, doctors at Norvic International Hospital found that his right coronary artery was diffused (totally blocked) at two places. Dr Bharat Rawat conducted an angioplasty on him Thursday morning and inserted two stents in the artery.Keshav Adhikari, now 33, was happily married with a son and a daughter and a decent job at Soaltee Crowne Plaza. He looked perfectly healthy -- he still does -- but he had a heart attack while playing volleyball with colleagues at the hotel premises on September 31, 2008.“I felt sudden pain in my chest and thought it was due to the exertion of jumping while playing. I went outside the court and asked my friends to take me to hospital as the pain persisted for a while,” Adhikari reminisced.
Around 20 percent of the total patients admitted at the Gangalal Heart Center with heart attack or near attack are below 40 years
Almost all of such young patients are smokers
Smoking, stress, sedentary lifestyle and unhealthy eating habits are major risk factors for coronary heart disease that we can control
Middle level executives under greatest professional stressDr Rawat recalls that Adhikari had a massive heart attack and his main artery was totally blocked. “We did an emergency angioplasty and he survived,” Dr Rawat added.These two are not isolated cases but rather part of a chilling trend in the urban population. As urban youths are making more money and leading a more comfortable life, they are becoming more vulnerable to heart disease.“Around 20 percent of patients admitted at Shahid Gangalal National Heart Center with Acute Coronary Syndrome (heart attack or near attack) in the last couple of years (923 in 2008 and 962 in 2009) were below the age of 40,” said Dr Bhagawan Koirala.And according to Dr Rawat, the corresponding figure at Norvic is around 15 percent and added that there used to be hardly any young heart attack patients about a decade ago.“Urban youth are very vulnerable to heart disease. Professional success is often achieved at the cost of health. No time for relaxation, no time to do something about other priorities in life. The food intake is all junk food, readymade or fast food which is salty and rich in fat. And the regular partying merely provides an opportunity to drink and to munch on unhealthy snacks,” Dr Rawat said, summing up the scenario for the successful young professional.Dr Koirala said almost all under-40 heart patients admitted at Shahid Gangalal are smokers, and called smoking the biggest risk factor for heart disease. “Smoking, stress, sedentary lifestyle and unhealthy eating habits are major risk factors for coronary heart disease that we can control,” he said.Both Thakuri and Adhikari, mentioned above, used motorcycles and hence did not walk much. Both consumed alcohol only moderately but while Thakuri was a smoker and had a family history of heart problems, Adhikari was a non-smoker and didn´t have any family history of heart attacks.“I love eating meat and as I worked at a hotel I used to have a lot of fried meat, especially pork, and meat items,” Adhikari said, explaining the probable cause of his heart attack.Worryingly for young professionals, Dr Koirala opined that middle-level executives are under greater professional stress.“The lower levels have to just take orders while the ones at the very top can always take a break if they feel that the stress is getting too much. It´s the ones in the middle that are under constant stress due to the pressure of deadlines and competition for professional growth, and are hence more vulnerable,” Dr Koirala explained.He stressed a healthy work environment, called smoking the biggest threat not just for heart disease but a myriad other ailments, and said one should dedicate at least an hour daily for exercise, adding that he himself ignores everything except his patients to find an hour for tennis or other physical activity.Dr Rawat has devised a simple formula to keep one´s heart healthy. “Please ask yourself every night: Have I MADE my day today?” Dr Rawat said, explaining that M stands for mental relaxation, A for avoiding tobacco and alcohol, D for diet control and E for exercise.