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Why seemingly healthy individuals may die of a heart attack
Most people who died of a heart attack had a known history of heart disease, particularly coronary heart disease or heart failure.
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Mourning: Singer Bunga Citra Lestari (right), the wife of actor Ashraf Daniel Mohammed Sinclair, hugs her son Noah Sinclair during the Malaysian artist’s funeral at San Diego Hills Memorial Park in Karawang, West Java, on Feb. 18. Ashraf is suspected to have died of a heart attack. (Antara/M Ibnu Chazar)
T
he sudden death of actor Ashraf Sinclair, 40, has shocked many in Indonesia and Malaysia, his home country. Prior to his death, the husband of singer Bunga Citra Lestari was known to have a healthy lifestyle with an ideal physical appearance and no significant history of heart or any other disease. Those attributes would easily confuse many people, considering he reportedly died of a heart attack, which classically targets older people with unhealthy lifestyles or with obvious histories of heart disease.
In 2011, another young actor and politician, Adjie Massaid, also died of heart attack at the age of 43 after playing futsal. A famous singer, Mike Mohede, is also known to have died of a heart attack at the even younger age of 32 despite his apparent health. Those three cases are clear examples that younger individuals without a prevalent history of any particular disease are not safe from heart attacks.
Heart attacks are more commonly found in males because of the heart-protective attributes of the estrogen hormone in females. Estrogen helps the metabolism of fat, which lowers the risk of heart disease among women. However, after menopause, the rate of heart disease, including heart attacks, among both genders becomes equal.
Most people who died of a heart attack had a known history of heart disease, particularly coronary heart disease or heart failure.
However, factors such as hereditary conditions may lead to sudden heart attacks. Such a condition, called congenital heart disease, often remains underdiagnosed and undetected for years, which then appears as a single deadly blow in adulthood.
As inherited heart disease may remain silent and without showing clear symptoms for years, people may assume they are disease-free. Heart attacks among those with congenital heart disease may also be provoked by particular precipitating environmental or modifiable factors. Thus, when the inherited or preexisting heart abnormality meets particular provoking factors, such as smoking, high cholesterol or blood sugar, excessive and vigorous physical exercise or emotional stress, the risk of a heart attack then becomes higher. This even applies to anatomically and functionally healthy hearts.
A heart with inherited ailments usually has structural and functional defects that compromise its ability to keep up with the body’s functional demands, which further exceeds its capacity during high-intensity sports and exercise. That is one possible answer why even an athlete could unexpectedly die of a sudden heart attack.
