With unusual winter weather in many parts of the country, especially North India, sudden winter deaths, usually in the early morning hours, are causing concern for all of us. News reports have complex problems. One of the latest reports talks about how 98 people died of heart and brain stroke in Kanpur, Uttar Pradesh alone. According to data released by the Lakshmipat Singhania Institute of Cardiology and Cardiac Surgery, Kanpur, 723 heart patients visited the emergency and outpatient department of the hospital in the last one week.

What is sudden cardiac death?

Sudden cardiac arrest occurs when your heart’s electrical system malfunctions and suddenly becomes disorganized. The heart beats dangerously fast and your ventricles may flutter or flutter (ventricular fibrillation). When this happens, the heart clearly can’t pump oxygen-rich blood and send it to the rest of your body. Without emergency treatment, a person loses his life within an hour of the onset of symptoms.

What are triggers for heart attacks on winter mornings?

There are many reasons that we need to understand and react appropriately.

(1) Circadian Rhythm: First and foremost, there can be a problem with the body’s circadian rhythm, which we commonly refer to as our internal body clock. It is responsible for controlling our time of wakefulness and fatigue. It dips and rises throughout the day, triggering the release of certain chemicals in your system, increasing and decreasing their amounts according to its peaks and troughs. Now when there is a problem with the circadian rhythm, an imbalance of these chemicals can occur. Researchers have already found that at around 6.30am, the circadian system sends out an increased amount of PAI-1 cells, which prevent blood clots from breaking down. The more PAI-1 cells there are in the blood, the greater the risk of blood clots that lead to a heart attack. This usually happens between 4 and 6 in the morning.

2) High blood pressure (BP): Your blood pressure rises due to vaso-constriction, or when blood vessels narrow and force the heart to pump more to keep core areas of the body warm. Now if your body is used to a certain blood pressure range, it may not adjust fast enough when it starts fluctuating in unexplained ways in response to external stimuli. So, if you feel that your heart beats per minute or the pulse rate is also fluctuating, avoid going out in cold weather. It is advised to stay indoors and wrap yourself in comfortable woolen clothes. The increased BP also puts pressure on the existing plaque to rupture and rupture, leading to sudden blockages.

3) Air pollution: When your air quality index is more than 450 and you are inhaling particles that disrupt the normal air flow during breathing, it increases blood clotting. The pollutants cause inflammation in the tissues of your body and platelets attach themselves to the inflamed points in the body, which leads to shortness of breath and blood clots. The associated reduced physical activity promotes platelet stickiness and aggregation.

4) Not consuming proper amount of fluids: Many people do not realize this but just because you do not feel thirsty enough in extreme cold, you do not hydrate yourself properly. This leads to serious issues of dehydration, blood volume is low, it becomes stickier and clot formation accelerates. Similarly, drink just enough and don’t overdo it as the lack of sweating in low temperatures means excess fluid can build up in the lungs and put a strain on the cardio-vascular system.

5) Lack of exposure to sunlight and consequently low levels of Vitamin D: In the absence of sunlight, our bodies are barely able to synthesize Vitamin D, which actually builds up in scar tissue in the heart after an episode. hinders construction. In this case, vitamin D supplement is needed.

What about prevention?

(1) I cannot stress enough the need to monitor your blood pressure at least once a week. And be sure to check your levels at different time slots to see 24-hour variations.
(2) Wear proper clothes while going out.
(3) Limit exercise outside the home and shift your regime indoors. You can do treadmill, weights and yoga. But make sure that your routine is as per the advice of the doctor. I would recommend stationary cycling as a good cardio-vascular activity for older adults as compared to the treadmill as it does not stress their knees and joints. Even a small amount of time devoted to cycling can reduce the rate of heart disease.
(4) Winter check-ups are more needed than summer, so don’t miss follow-ups as advised by your cardiologist.

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