Popular Bengali actress Aindrila Sharma, 24, died on Sunday after suffering from multiple cardiac arrests. A two-time cancer survivor, Aindrila was hospitalised on November 1 after suffering a brain stroke. According to reports, Aindrila underwent left frontotemporoparietal decompressive craniotomy. Experts say that cardiac arrest, heart attack and brain stroke are all closely related as they form part of disease process called atherosclerosis. The fact that Aindrilla suffered from cancer and underwent treatment for it could have predisposed her to cardiac arrest or stroke, say experts. (Also read: Bengali actor Aindrila Sharma dies at 24 after multiple cardiac arrests, Tollywood mourns her loss)
What is a cardiac arrest
“Cardiac arrest is a sudden and an abrupt loss of heart function. It usually occurs when there is a problem in the heart’s electrical system, making it difficult for the organ to pump sufficient blood to the brain, lungs and other organs,” says Dr. Atul Mathur – Executive Director, interventional cardiology and chief of cath lab, Fortis Escorts Heart Institute, Okhla Road, New Delhi.
Signs of sudden cardiac arrest are:
– Sudden collapse
– No pulse
– No breathing
– Loss of consciousness
How brain stroke, cardiac arrest and heart attack are related
“The brain stroke and cardiac arrest could be due to the clogging of arteries supplying the brain and the heart due to clots with or without cholesterol deposits but brain stroke can also follow a massive heart attack when any of the arteries are blocked and which causes formation of clot in heart and which actually migrates to brain and causes brain stroke. So basically, cardiac arrest, heart attack and brain stroke form part of a disease process called atherosclerosis. So, whenever there is an enhanced atherosclerosis (deposition of cholesterol plaques), because of stress, blood pressure, due to a drug, smoking, diabetes or any heavy exercise when your heart is not accustomed to it, the silent block that gets ruptured and that causes clot formation could lead to brain stroke or a heart attack. A severe heart attack can lead to cardiac arrest. Cardiac arrest is when heart completely stops and is unable to provide enough oxygen, blood, nutrients to different organs of the body, especially brain. So this is how brain stroke, cardiac arrest and heart attack are inter-related,” says Dr Sanjeev Gera, Director and HOD Cardiology, Fortis Hospital, Noida.
Can cancer or cancer treatment cause cardiac arrest.
“There is a relation between cancer itself with risk of cardiac arrest. Not only treatment the disease per se is linked with these instances. Cancer and malignancy increase the chance of clot in our vessels that happens mainly in the smaller vessels of legs and less likely in major vessels of heart, lung or brain. It is not the treatment; it is the disease itself. Patient who has cancer is at high risk of deep vein thrombosis which may lead to damage to heart, lungs and brain which can lead to blockage of these vessels which can result in cardiac arrest, lung failure or brain stroke,” says Dr. Atul Mathur – Executive Director, Interventional Cardiology and Chief of Cath Lab, Fortis Escorts Heart Institute, Okhla Road, New Delhi.
“In severe cases of intracranial hemorrhage or ICH, the patient may become unconscious and require a mechanical ventilator for breathing support. If associated with increased pressure on the brain or irritability, can cause sudden cardiac death due to variation in cardiac electrical function. It could happen due to hyper coagulable state due to underlying malignancy increases risk of multiple clotting or side effects of anti cancer drugs causing cardiac rhythm irregularities which throws clots to brain. Coronary heart disease (CHD) along with other complications, can lead to Myocardial infarction (MI), which can even result in sudden death. The illness conveys critical suffering, impacts mental health, and requires momentary expenses for the treatment that can be a burden on the individual and the family when it occurs at a young age,” says Dr Mathur.
Dr Gera says any cancer disease along with chemotherapy or radiotherapy can be associated with increased risk of heart attack or strokes.
“It is because of two things – one is cancer itself is a prothrombotic state this means it can lead to clot formation in the arteries of brain or heart which can cause stroke or heart attack. Another thing is because of chemotherapy. There are some anti-cancer drugs which cause low heart function, formation of clots in the heart, increase in inflammation due to radiotherapy which can cause heart attack or brain stroke,” says the noted cardiologist.
Dr Gera says there are some cancers which are predisposed to increase clot formation in arteries of heart which can cause heart attack.
“There are medication or drug that can cause less blood flow in heart arteries which can lead to clot formation. There are some medicines which are used in cancer therapy which can cause increased inflammation and increased damage to the internal lining of your arteries. Over that damage, platelet forms and clot formation can lead to heart attacks,” says the doctor.
How cancer affects heart
“Cancer can affect heart in many ways. It can cause rhythm disturbances, it can cause heart attacks, it can cause low heart function called heart failure especially there are few cancer medications that can cause low heart function that can lead to heart failure leading to fatigue, breathlessness, swelling over feet, eyes and whole of the body,” says Dr Gera.
“Cancer survivor patients especially, breast cancer can have side effects of chemotherapeutic medications. Medications like adriamycin, cisplatin can affect your heart. The cancer patients must follow up with 2D echo to look for heart function and timely medications like beta blockers and ace inhibitors,” says Dr Ankur Phatarpekar, Director Cath Lab and Interventional Cardiologist, Symboisis Hospital, Dadar.