New Delhi, March 4
Persistent chest pain and discomfort among teenagers can no longer be taken lightly. It could be a warning sign of sudden cardiac death or acute coronary heart disease which results from blocked arteries, raising the risk of heart attack as oxygen and nutrient flow to the heart reduces.

This week, intervention cardiologist Dr Purshotam Lal performed a rare coronary angioplasty with stenting in a 14-year-old boy, who was suffering from chest pain that had lasted for two years.

Dharmendra Kumar, a class VII student from UP’s Etawa, appeared healthy, had no family history of coronary heart (or artery) disease, but was suffering acutely from it. “Had he not received medical attention, he would have suffered sudden cardiac death in months, even days,” Dr Lal told The Tribune today.

He said an epidemic of cardiac artery disease had set in among teenagers and the symptoms in most youngsters were being ignored by parents and even by top cardiologists who don’t believe children could suffer from coronary heart disease whose symptoms include chest discomfort mostly during exercising and climbing stairs.

Lal said policymakers must include in the National School Health Programme monitoring of blood pressure, sugar and cholesterol to track students’ health.

“Before 2005, I had not seen a single teenager with symptoms of coronary heart disease. Now, it’s a routine to see those aged less than 20 years in our OPD,” he said.

“Incidentally, Dharmendra had first gone to a noted cardiologist in Mumbai who failed to diagnose his condition. We managed to evaluate him with non-invasive tests including the treadmill test which showed ischemia. We then performed coronary angiography, which revealed 90 per cent blockage in the left main artery which meets three-fourth of the heart’s blood supply. Urgent coronary angioplasty was then done and the blockage removed. In the absence of this, the child would have faced sure death,” Lal said.

The cardiologist has seen several youngsters below the age of 20 suffering heart attacks. These include those who had earlier complained of chest discomfort while running or sometimes without movement.

“Chest pain could be muscular but it should not be ignored. In three months, four teenagers came to us after suffering sudden heart attacks. They survived because their main left artery was not blocked and one of the other two arteries was. However, such patients have a bleak future. After heart attack, their left ventricle, the main blood-pumping chamber of the heart, becomes extremely weak. This reduces the cardiac output to about 20 per cent. It means a 20-year-old will resemble a 60-year-old in energy levels,” Lal said.

Most of these patients are on treatment but have had to discontinue studies. “They are unable to cope up due to a weak heart. That’s why we insist on catching them early. One of my patients was an engineering student,” he said.

Research on risk factors behind coronary heart disease symptoms among children and young adults is very meagre. “Dharmendra was a non-smoker and was healthy otherwise. New studies need to be commissioned to determine risk factors,” Dr Lal added.