Chronic stress and lack of sleep are risk factors for silent arrhythmias: what you should know

Most people associate heart diseases with dramatic warning signs such as crushing chest pain, breathlessness or sudden collapses. But there is another category of warning signs of cardiac disorders that progress quietly. These disorders, one of which is arrhythmia, do not have obvious symptoms. With chronic stress and advanced age being risk factors, and India’s population increasingly stressed and rapidly ageing, arrhythmia is now on the rise in our country.

Understanding arrhythmia

Arrhythmia is an abnormality wherein the electrical rhythm of the heart may beat too slowly, too fast or in an irregular manner. Some of these disturbances are harmless but others can lead to an increase in heart failure, stroke or even sudden cardiac arrest, if left undetected for long periods.

One of the most common cardiac rhythm disorders is atrial fibrillation, also known as AFib. This is a condition wherein the upper chamber of the heart beats irregularly as well as inefficiently. Globally, ventricular arrhythmias are considered dangerous because they lead to sudden cardiac death. Atrial fibrillation, the commonest arrhythmia, is a major risk factor for stroke as irregular heartbeats can allow blood clots to form and travel to the brain. And yet, many individuals tend to remain unaware of this condition.

What makes arrhythmia particularly dangerous, is that many individuals tend to dismiss the symptoms or mistake them for anxiety, fatigue or even exhaustion caused by modern lifestyle trends, making arrhythmia a major silent cardiac concern.

Signs and symptoms

Unlike a cardiac arrest, arrhythmia does not announce itself loudly. Some of its symptoms are mild and others are inconsistent – these include occasional palpitations that an individual faces, skipped heartbeats without a particular circumstance, dizziness, inconsistent or disturbed sleep, sudden fatigue without extreme activities to tire out the individual and brief episodes of the individual getting breathless.

The main concern is how arrhythmia progresses quietly. An individual may experience abnormal rhythm for a few minutes or for several hours before the heart rate turns normal. In many cases, by the time a patient undergoes an ECG, the heart rate has normalised and the test appears to be completely fine. This is one of the main reasons diagnosis gets delayed.

The causes

While rhythm disorders were traditionally seen in older adults, they have now also become a growing concern in younger adults who have no major structural heart problems. Today’s urban lifestyle creates a perfect environment for rhythm disturbances with chronic stress, long working hours, sedentary habits, binge eating, smoking and excessive drinking often linked to disruptions in the stability of the heart. Sleep deprivation in younger adults is also a leading cause in young adults, since the body’s internal regulator influences the heart rate and poor sleep tends to affect the autonomic nervous system.

This apart, arrhythmia can be caused by conditions such as age, hypertension, diabetes, obesity and thyroid disorders too.

Staying aware

Symptoms can be intermittent and mild, and so, it is crucial to stay aware of signs and symptoms.

Wearable devices such as smart watches have increasingly started to detect irregular heart rhythm during routine activities that the individual is used to, and hence, fitness trackers do help to an extent. But it is important to understand that while smart watches may function as basic screening tools, they are not diagnostic tools, and false alarms could cause anxiety and panic. If a fitness watch detects irregular rhythms, it is crucial to seek a prompt medical evaluation — this is one of their biggest uses.

Staying aware, ensuring you lead as healthy a lifestyle as possible and seeking prompt medical attention when symptoms arise are all important to keep in mind when it comes to arrhythmias.

(Dr. Babu Ezhumalai is a senior consultant in interventional cardiology, structural & endovascular interventions, MGM Healthcare, Chennai. babu.ezhumalai@mgmhealthcare.in)