27-year-old Indian expat in UAE shocked to find out hidden villain behind massive heart attack

Abu Dhabi: Rajesh Rajendran thought it was just gas or acidity. The 27-year-old Indian expat from Kerala, who has worked in the UAE for the past four years, was on his way to LLH Hospital, Musaffah, with chest pain he assumed would pass.

Then, just as he neared the Emergency Department, the pain turned severe. Within a short span, his condition worsened and he collapsed in cardiac arrest. The emergency team responded quickly, delivering 10 minutes of cardiopulmonary resuscitation (CPR) followed by a 30-minute emergency angioplasty, and brought him back from the brink.

World Heart Day observed on September 29 is a reminder that a heart attack does not always come with a warning label. This year’s theme "Don't Miss a Beat" aims to raise awareness about hidden or overlooked cardiovascular disease symptoms.

However, Rajesh had no comorbidities or other symptoms. Common conditions that can cause or worsen heart problems, such as high blood pressure, diabetes and chronic kidney disease, were not part of his story. And he was shocked to find out the villain behind the massive heart attack.

Rajesh suffered an ST-segment elevation myocardial infarction (STEMI), one of the deadliest forms of heart attack, caused by complete blockage of one of the heart's main arteries. Because a STEMI can deteriorate within minutes to an hour, emergency intervention was crucial.

"It can trigger dangerous heart rhythm disturbances leading to sudden cardiac arrest,” Dr Arun Hari, Specialist, Cardiology, who treated Rajesh at the Abu Dhabi hospital told Gulf News.

“It stops blood supply to part of the heart muscle, and without urgent treatment, that portion can become permanently damaged. Had the cardiac arrest occurred outside the hospital, survival might not have been possible," he pointed out.

In such cases, the first hour, often dubbed the "golden hour", is imperative. The earlier the treatment, the higher the chances of survival and the better the long-term recovery. "Immediate CPR is lifesaving. It helps maintain blood flow to the brain and vital organs until the heart starts beating again. Early CPR significantly improves survival and reduces the risk of brain injury," the doctor explained.

For Rajesh, after about 10 minutes of sustained CPR, the heart was revived and began pumping blood effectively without external chest compressions. That allowed the medical team to perform emergency angioplasty within 30 minutes. Early angioplasty reduces complications, improves heart function, shortens recovery time and significantly increases survival rates.

So what caused a heart attack in a young man with a clean bill of health? According to Dr Arun, smoking was the only significant factor in this case.

"Smoking damages blood vessels, increases clot formation, and reduces oxygen supply to the heart. Even in young individuals, it can cause sudden blockage of a coronary artery, leading to a heart attack or cardiac arrest," he explained.

Rajesh had smoked about one packet of cigarettes a day for seven to eight years. He was shocked to learn that smoking was the real villain in his case.

"I couldn't believe I had a cardiac arrest at this age because of smoking. When the pain started, I thought it would go away. I remember the pain becoming intense, but didn't realise it was serious," he recalled.

The episode has been a reality check. "I am grateful to Dr Arun for giving me a second chance in life. This experience has completely changed my perspective on health. I have quit smoking and decided to follow a healthier lifestyle," said Rajesh.

Smoking is most often linked with cancer, but chronic smoking can also trigger sudden cardiac arrest, even among younger, otherwise healthy people. Gone are the days when cardiac arrests happened only to older people, said Dr Arun, with heart attacks increasingly seen among younger individuals.

Lifestyle factors such as smoking, chronic stress, poor sleep, an unhealthy diet, obesity, a sedentary lifestyle, substance use and lack of exercise are contributing to the trend, even in people without traditional risk factors.

"Too much of karak tea and smoking is a deadly combination seen among many people here. In some individuals, genetic factors may also play a role. Many young people dismiss chest pain as acidity or muscle pain. Other warning signs include chest tightness, pain radiating to the arm or jaw, sweating, breathlessness, nausea, or sudden fatigue. Persistent chest discomfort should never be ignored," cautioned Dr Arun, urging people with these symptoms to seek immediate medical help.