Gone Too Soon

The Rise of Young Heart Deaths

By Nalin Balasuriya

nbalasuriya@gmail.com

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Cardiovascular diseases (CVD) are conditions that affect
1. the heart
2. the blood vessels

Deaths resulting from major circulatory system diseases in 2020

Deaths from circulatory system diseases

Cerebrovascular diseases

4,962

Ischaemic heart disease

15,761

Other heart diseases

7,974

Hypertensive diseases

4,266

Hypertensive diseases: Problems from high blood pressure, e.g., heart failure, stroke risk.

Ischaemic heart disease: Narrowed arteries reduce blood to the heart, causing angina or heart attack.

Other heart diseases: Includes cardiomyopathy, arrhythmias, congenital defects, and inflammation.

Cerebrovascular diseases: Blood vessel disorders in the brain, mainly stroke and TIAs (Transient Ischemic Attacks).

The human heart

The human heart, about the size of a fist, is the body’s strongest muscle. It begins beating just three weeks after conception and, by age 70, will have beaten 2.5 billion times. Through 97,000 km of blood vessels, it pumps blood to deliver oxygen and nutrients while removing waste.

What happens during a heart attack

Aorta

Superior

vena cava

Left main

coronary artery

Site of

blockage

Blood

supply

blocked

Right

coronary artery

Dead heart muscle tissue

When the coronary arteries (heart arteries) that supply blood to the heart muscle become narrowed or blocked by fatty deposits called plaques, blood flow and oxygen to the heart are reduced. This can cause chest pain, known as angina.

coronary artery

Plaques

Narrowed

artery

Blood clot

If a coronary artery becomes completely blocked — often by a blood clot forming on a ruptured plaque — the part of the heart muscle supplied by that artery is starved of oxygen and nutrients. Within about 30 minutes, heart muscle cells begin to die. Most damage occurs within 6–12 hours.

Common heart attack symptoms

Pain or discomfort spreading to the shoulders, arms (especially the left arm), back, neck, jaw, or upper abdomen.

The areas where pain is most likely felt
Areas where pain is most likely felt
Many heart attacks are mistaken for gastritis because early symptoms can feel similar — a delay that can be deadly.

Lightheadedness, dizziness, or fainting

Nausea or vomiting

Shortness of breath — with or without chest pain

Chest pain, pressure, tightness, or discomfort — often lasting more than a few minutes, or coming and going

Fatigue or unusual tiredness, especially in women

Cold sweating

Man clutching chest showing symptoms
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2
3
4
5

Premature Mortality Trends of Ischemic Heart Disease
in Young Adults (25–44): 2010–2020

Visualizing the increase in heart disease deaths

Major cardiovascular disease (CVD) risk factors

Non-modifiable Risk Factors (cannot be changed)

Age icon

Age: The risk of CVD rises with age as arteries naturally become stiffer and plaque can build up over time.

Sex icon

Sex: Men generally face a higher risk of heart attack earlier in life, though the risk for women increases after menopause.

Family history icon

Family history (Genetics): Having a parent or sibling with CVD increases one’s own risk, particularly at younger ages.

Modifiable Risk Factors (can be changed)

High blood pressure icon

High blood pressure: Increases strain on the heart and arteries, raising the risk of heart attack and stroke.

High cholesterol icon

High cholesterol: Promotes plaque buildup in arteries, reducing blood flow to the heart and brain.

Diabetes icon

Diabetes: High blood sugar damages blood vessels and accelerates plaque buildup.

Smoking icon

Smoking: Damages the lining of arteries, increases blood pressure, and reduces oxygen in the blood.

Physical inactivity icon

Physical inactivity: Lack of regular exercise contributes to obesity, high blood pressure, and poor cholesterol balance.

Unhealthy diet icon

Unhealthy diet: Diets high in salt, saturated fats, and sugar raise cholesterol and blood pressure.

Obesity icon

Obesity: Increases blood pressure, cholesterol, and risk of diabetes — all of which heighten CVD risk.

Alcohol icon

Excessive alcohol consumption: Raises blood pressure and triglyceride levels, damaging the heart muscle.

Emerging Risk Factors

Stress icon

Stress: Chronic stress can lead to inflammation, high blood pressure, and unhealthy coping behaviours.

Sleep icon

Poor sleep: Inadequate or poor-quality sleep can raise blood pressure and contribute to obesity and diabetes.

Air pollution icon

Air pollution: Long-term exposure to air pollutants can damage blood vessels and increase the risk of heart disease.

Inflammation icon

Chronic inflammation: Persistent inflammation in the body contributes to the development of atherosclerosis.

Socioeconomic factors icon

Socioeconomic factors: Low income, limited access to healthcare, and social stress increase vulnerability to CVD.

Immediate Actions in Case of a Heart Attack

Call Ambulance Service

Call Ambulance Service (1990)

Seek admission to the nearest suitable hospital right away.

Give Aspirin

Give Aspirin (if safe)

If the patient is conscious and not allergic, let them chew one aspirin to help reduce blood clotting.

Keep Patient Still

Keep Patient Still

Sit them down, keep them calm. Loosen any tight clothing. Do not let them walk.

Check Breathing & Pulse

Check Breathing & Pulse

If they stop breathing, start CPR immediately.

Reassure the Patient

Reassure the Patient

Stay calm and speak gently — don’t frighten them.

“According to cardiologists, about 40% of patients die at the very onset of a heart attack. Only around 60% survive long enough to reach a hospital for admission and treatment.”

Heart attack survival chart

Survive to hospital admission:

60%

Sudden cardiac death:

40%

Sources: World Health Organisation (WHO), Mayo Clinic, Sri Lanka Heart Association, Department of Census and Statistics