THE phone call in mid-morning took K. Selvi by surprise. It was not from a familiar number and the man on the other end sounded incoherent.
But Selvi could make out her husband's name being stated repeatedly amidst loud background noise.
She knew that her husband was at the gym, doing his usual routine with his personal trainer.
It took some time before Selvi realised that the person on the other end was her husband's trainer, calling to deliver the news that her husband had collapsed in the midst of an exercise session and had been rushed to hospital by ambulance.
When Selvi arrived at the hospital, she was given the devastating news that her 50-year-old husband had been declared dead upon arrival. While still numb with shock, she was told that her spouse had suffered a fatal heart attack.
For Selvi and her two teenage children, the tragedy, five years ago, is something they have never fully recovered from. Her husband's death was all the more shocking because he had always been careful about his health.
In fact, since his own father had died of a heart attack at 55, Selvi's husband had been determined to avoid the same fate. He had seemed healthy right up to that tragic episode.
Losing a loved one unexpectedly leaves a deep void in the family.
They are left to pick up the pieces of their shattered lives, trying to make sense of what has happened. They struggle to understand the tragedy and live with the guilt of whether anything could have been done to prevent it.
The impact of losing a loved one has far-reaching consequences.
Research published in 'JAMA Network Open' indicates that bereavement may even accelerate ageing. The study, by Columbia University, notes that those who have lost loved ones experience faster "biological ageing".
UNDIAGNOSED HEART PROBLEMS
The recent incident involving a 17-year-old Chinese badminton player who collapsed on court after suffering cardiac arrest during the Asian Junior Championships in Yogyakarta, Indonesia, highlights the fact that sudden death can happen to anyone, even young and apparently healthy individuals.
In Malaysia, data from the Statistics Department on Causes of Death 2023, highlights heart disease as a leading cause of sudden death among young adults in 2022.
There are a few possible causes for sudden death during vigorous physical activity, explains Malaysian Family Medicine Specialists Association president Dr Nor Hazlin Talib.
Heart-related sudden deaths during vigorous physical activity are often due to undiagnosed heart problems such as heart muscle disorders, electrical abnormalities, infections weakening the heart muscle, or congenital abnormalities of the coronary arteries.
"These individuals may appear healthy but could have been living with undiagnosed underlying heart conditions which can lead to sudden cardiac arrest during exertion.
"Other possible causes could be dehydration and electrolyte imbalances following intense physical activity."
While sudden death during vigorous physical activity can be terrifying and perplexing, Dr Nor Hazlin adds that the overall risk of sudden death during vigorous activity is low, occurring at a rate of one per 1.51 million episodes of exacerbation for men and one in 36.5 million hours of exertion for women.
The likelihood of sudden death for both men and women is even lower for those who exercise regularly, she adds.
In fact, numerous studies have consistently shown an association between moderate aerobic exercise with a decreased risk of coronary heart disease and death.
Even a small amount of exercise provides significant risk reduction compared to a sedentary lifestyle.
"Therefore, the benefits of being physically active far outweigh the small risks associated with exercise."
MODIFIABLE RISK FACTORS
Dr Nor Hazlin says in addition to exercising and maintaining an ideal body weight, it's important to address other modifiable risk factors for sudden cardiac death such as smoking, high cholesterol, diabetes and hypertension.
Regular visits to a primary care physician are essential for managing these risk factors.
While physical fitness is beneficial for overall health, it's important to acknowledge that sudden death during vigorous physical activity can occur due to various underlying conditions, she says.
The best approach is to maintain a healthy lifestyle and undergo regular health screenings as well as check-ups.
Regular health screenings play a crucial role in detecting these conditions early and preventing tragic incidents.
MONITOR HEART RATE
Fitness influencer and certified personal trainer Kevin Zahri says there was a study done many years ago that said a marathon or ultra-endurance athlete is more likely to die of heart failure/attack versus a couch potato.
The reason being that the "engine" (the heart) of the marathon or ultra-endurance athlete is under more stress compared to a couch potato.
"To avoid or limit risks, we always encourage athletes to invest in a heart rate monitor to monitor their heart rate."
Always monitor your heart rate and breathing, and listen to your body, says Kevin.
Cardiovascular diseases are the leading cause of death globally, accounting for 17.9 million fatalities annually, according to the World Health Organisation.
But in Malaysia, people are getting heart attacks at a younger age compared to those in developed countries. In Malaysia, the average age at the onset of the first heart attack is 55-58 years, while it's 65 years in developed countries.
EXERCISE OVERLOAD
PERSONAL trainer Kevin Zahri cautions gym goers/exercise enthusiasts about certain symptoms which may indicate that the body is struggling and can't cope with the exercise load.
These include:
• Nausea
• Lightheadedness
• Dizziness
• Difficulty breathing
• Coughing or being unable to speak during exercise (running out of breath)
• Profuse sweating