Traditionally, heart disease occurs in people around the ages of 65 and above. This was what cardiologists thought until a decade ago as they attributed heart attacks to changes in the arteries and blood vessels of the heart with age. However, as the UAE registries and worldwide data indicate, heart attacks are occurring at a far younger age.

Dr Sebastian says: “Instead of patients being in their fifties, a majority of heart patients in my clinic are in their thirties and forties. In fact, my youngest heart attack patient is only 21 years old and he suffered a heart attack because of his smoking habits. He had to undergo angiography and angioplasty for an arterial blockage and has a stent in one artery now. So the situation is really alarming.”

It is not just age; men have a natural propensity to heart disease. According to the Harvard Men’s Health Watch (HMHW), men are more susceptible to heart attacks than women, and need to be extra vigilant for tell-tale signs. The publication pointed out that about 10 per cent of all heart attacks occur in men before the age of 45 and nearly 80 per cent of these attacks happen due to Coronary Artery Disease (CAD), which occurs due to the collection of high cholesterol in the main arteries of the heart, forming a plaque.

The other big factor for CVD and heart attacks among Asians is the habit of smoking, incidence of diabetes and the existence of high levels of stress.

Dr Sebastian added that in the UAE one could see a reflection of the same phenomenon at a microcosmic level, amongst the expatriates from South Asia here. “In the UAE we see a higher incidence of heart disease among South Asians particularly Indians. I have patients’ relatives often coming in to tell me that the patient who had a heart attack was facing high stress, chasing huge targets in office, suffered job insecurity or actually lost his job, days before the heart attack. It is such patients who follow unhealthy diets, are habitual smokers and face high stress, that suffer from early cardiac episodes. India is literally the head quarters for Type II diabetes as well as high stress which is the main trigger for heart attacks.”

These symptoms can further be accompanied by nausea, indigestion, heartburn or abdominal pain, shortness of breath, cold sweat, fatigue, lightheadedness or sudden dizziness.

I have had four heart attacks. At least, that’s what I thought. Each time the ECG and blood test told a different story. There’s no heart attack. Must be heartburn, the doctors at the Emergency ward told me.

In between the four visits to the hospitals, I have had chest pains on numerous occasions. I have lost count of them. But each time a couple of antacid tablets would help.

Yes, I’ve consulted Dr. Google many times. It only served to magnify my fears. I seemed to have every symptom described there.

Then there are the videos on heart attacks and heart health that tend to flood my WhatApp groups. A particular one by Dr Devi Prasad Shetty, a cardiac surgeon in Bangalore, caught my attention. What Dr Shetty said was very enlightening.

One question was: How do you distinguish between a heart attack and heartburn (caused by stomach acidity or acid reflux)? It’s very difficult even for doctors, he said, adding some symptoms are identical.

So what do you do? The prudent thing would be to rush to a hospital. A hospital, not a clinic, since many clinics won’t be equipped to deal with such an emergency. A clinic is an option only when access to a hospital is difficult.

I harp on this because I lost a friend who decided to drop into a clinic for chest pain. The doctor could not find any anomaly in the heart rate but advised him to go to a hospital, which he didn’t. He must have thought, “Why should I go to a hospital when the doctor didn’t find anything wrong”? He ignored the doctor’s advice. And paid the price around six hours later. He suffered a cardiac arrest, and no one was home.

So I take chest pains very seriously. Sometimes my left hand hurts, the pain seeps up the arm. That’s when I rush to the Emergency. It turned out to be a false alarm four times. Each time, it was a huge relief.

I have had heartburn for a very long. My bloated stomach is a source of mirth to my wife and daughter. I’m aware of acid reflux and its symptoms, but the risk of a heart attack is always at the back of my mind.

I’m Indian, which puts me in a high-risk category. And therapy for my lymphoma included a cocktail of medications, any one of which could increase the chances of a heart attack. This is my fear. The doctors didn’t say it.

When the next chest pain refuses to go away, you will find me in an Emergency ward with ECG electrodes stuck to my chest. I’m serious: cross my heart.

The following are the different medical terms for a heart attack, described by the American Heart Association:

Acute coronary syndrome (ACS): This is an umbrella term to refer to situations when the blood supply to the heart muscle is blocked suddenly.

STEMI: ST-elevation myocardial infarction is caused by a complete blockage in a coronary artery.

NSTEMI: A non-ST-elevated myocardial infarction is one in which an artery is partially blocked and severely reduces blood flow.

Myocardial infarction (MI): It’s the medical term for a heart attack. “Myo” means muscle, “cardial” refers to the heart, and “infarction” is death or destruction of tissue due to lack of blood supply.

Coronary thrombosis: Formation of a clot in an artery that supply blood to the heart muscle.

Coronary occlusion: An obstruction of a coronary artery that results in lack of blood flow to a part of the heart muscle. It is a cause of heart attack.