Study of various risk factors and cardiac pathology (mainly atherosclerotic coronary artery disease) in young adults- an autopsy based prospective study

Author: 
Dr. Vedant Kulshrestha

Cardiovascular disease is now the most common cause of death worldwide. The sudden death in apparently healthy young individuals is always a devastating and shocking event. According to WHO, Ischemic Heart Disease is our modern epidemic. The occurrence of Ischemic Heart Disease in developing countries is a decade earlier compared with the age incidence in developed countries. Now because of change in lifestyle and habits, atherosclerotic coronary artery disease is noticed in comparatively younger age group even in a developing country like India. Bangalore is an IT hub. Many IT Professionals are working in this city. We have noticed atherosclerotic coronary artery disease, occurring in young IT professionals because of their sedentary lifestyles, smoking and drinking (alcohol) habits. Hence an autopsy based prospective study was conducted at the department of Forensic Medicine, Victoria Hospital, Bangalore Medical College & Research Institute, Bangalore, over a period of 18 months from November 2013 to May 2015, in young adults aged between 18 to 40 years dying due to various reasons like road traffic accidents, poisoning, burns, hanging, sudden natural deaths, assaults, electrocution, snake bite etc, and autopsy findings of total 200 cases subjected for medicolegal autopsy were studied, to know various risk factors associated with cardiac pathology (mainly atherosclerotic coronary artery disease), so that we can counsel the close family members of the deceased and other individuals to go through essential investigations and take preventive measures. In this way we can protect the close family members of the deceased and other individuals from fatal cardiac pathologies (mainly atherosclerotic coronary artery disease) in future. Out of 200 cases, majority of cases 143 (71.5%) cases showed underlying Atherosclerotic Coronary Artery Disease of different grades and different extent of luminal narrowing which also included fixed coronary obstruction, thrombus, recent and healed Myocardial Infarction. Most of them were male belonged to 26-33 years age group.
Other significant cardiac lesions encountered were Pericarditis, Valvular heart disease including Rheumatic heart disease, Arrhythmogenic Right Ventricular Dysplasia, Myocarditis, Concentric Left ventricular hypertrophy, Biventricular hypertrophy, Cardiac Polyp, Anomalous/Aberrant Coronary artery, Hypertrophic cardiomyopathy, Dilated cardiomyopathy, Pancarditis and Coronary artery Vasculitis. In most of the cases these other underlying cardiac pathological lesions were found in association with atherosclerotic coronary artery disease.
Both frequency and duration of smoking (cigarette/beedi) and alcohol consumption, lack of physical exercise, history of respiratory diseases, family history of hypertension, age, sex and BMI showed significant relationship with cardiac pathology mainly atherosclerotic coronary artery disease. In case of IT Professionals, daily working hours, working days in a week and monthly holidays did not show any statistically significant relationship with the cardiac pathology. Heart weight was also found to increase with body weight, body length and BMI.
Atherosclerotic coronary artery disease was the most frequently encountered underlying cardiac pathology even in young adults. It is a matter of concern. People should stop smoking cigarettes/beedis and reduce the consumption of alcohol, do some sort of moderate physical exercises regularly, focus on the dietary habits to maintain normal weight, check their blood pressure and sugar levels at regular interval and take proper medications.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2020.21562.4238
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