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Death due to massive heart attack after martial art class

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My husband passed away of massive heart attack a few weeks ago. He was 45 years old and pretty healthy. However, he had been having the high cholesterol level for years. He was getting the medical check ups regularly and every time he was told about the cholesterol problem. Every time he was given the cholesterol pills for a month. He always took them, but they didnt help and he had never been told that he had to take them for a life time. The tragedy happen in the sport club, it was the martial arts art school. He fainted after the class. Emergency team arrived very fast, but they couldnt help. My question is: could this martial arts class affect or cause the heart attack. The class was at the late evening since 8 pm till 10:30 pm.
The autopsy doctor said that his heart artery was about 90% blocked by the cholesterol. However, I still think that the sport class could worsen the situation.
Please, explain it to me. Please.

Category: Cardiologist

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Category: Cardiologist
Dr. Vivek Mahajan is online now

Expert:  Dr. Vivek Mahajan replied 4 Days.


Thank you for your query at I am sorry for your loss.

Your husband had a cholesterol problem for a long time and he was taking medications which were not beneficial. The specific details of the disorder are not made available to me but if the cholesterol isn't controlled then the drugs have to be titrated and if necessary new drugs have to be added.

The fact that he had coronary artery blockage of 90 percent and had sudden death means that he had possibly an acute coronary event likely a heart attack and an arrhythmia like ventricular tachycardia. Heart attack can occur at rest or on exertion and it is not necessary that a patient needs to exert to have a heart attack. Theoretically exertion can increase the chances of having a heart attack. But it is next to impossible to say that the exertion caused heart attack. It may or may not have contributed. All we can conclude is that it could have increased his chances of having a heart attack precipitated.

Also he never had a chest pain and was fit, and doing all the exertional activities without any problem. There are many other things which could contribute to the attack like mental stress, hypertension, diabetes etc. Theoretically yes but it cannot be proven that the martial art session was responsible for bringing out the heart attack.

Hope it helps. Please let me know if you have any follow-up queries.

Patient replied :

May the fact that exercises were taken in the late evening after 8pm increase the risk of the heart attack? My friend, who is the gymnast insists that the late exercises should be prohibited for the people after 40 y.o., that it could increased his possibility for the heart attack. What do you think about it? And how the exercises can affect this problem. May be he didn't have to go to this martial arts school at all? He had been going there just since May 2013. Sometimes he complained about getting tired after the class, but then the next day he was ok again.
I am just wondering, if he stayed home that evening, could he be still alive?

Expert:  Dr. Vivek Mahajan replied 3 Days.


Thanks for the follow-up. I think i understand what you are going through.

There is no definite evidence as to exercises being harmful. Most heart attacks occur in mornings. As to whether this exertion could have brought about this attack. Yes it could have caused the heart attack. By increasing the heart rate and BP it increases the risk of rupture of plaques already existing in the coronary artery. So there's a theoretical possibility that the attack might have been brought about by exertion. But one cannot say with surety.

He could have been alive or else any other slight insult could have brought the attack. Unfortunately, it is not like math where one can predict the results. Also evaluation when he complained of fatigue could probably have been more beneficial than avoiding exercise without evaluation.

Hope i have answered your follow-up questions. Please feel free to discuss further.

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
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