After Godfrey Gao: How does cardiac arrest happen when someone looks fit?
The sudden death of Taiwanese-Canadian model-actor Godfrey Gao last week (Nov 27) came as a shock to many. Here was a man who looked like he worked out and took care of himself: Muscle tone, enviable abs and an athletic disposition.
Yet, the 35-year-old succumbed to cardiac arrest while filming a Chinese variety series in Ningbo, China. Gao had collapsed while running from obstacle to obstacle during the physically demanding show, and died after three hours of rescue efforts.
His death shocked many fans and netizens, with one posting, "I still can't believe he is gone. He looked so healthy". And therein lies the disbelief. How could someone who looked as fit and healthy as Gao die of a cardiac arrest? If a well-built body isn't a good indication of health, what is?
Here's why you shouldn't judge a book by its cover – or in this case, your health by your built.
"Good muscle tone is mainly a cosmetic quality and probably does not reflect (a person's) health status," said Dr Kelvin Wong, cardiologist from Mount Elizabeth Hospital, who added that being slim is "no guarantee of good health" either.
Dr Kenneth Ng, consultant cardiologist at Novena Heart Centre, agreed: "Looks can be deceiving. You cannot really tell whether a person is healthy or fit by appearance". Blood pressure, glucose and cholesterol levels are better determinants of whether the person is healthy than judging how chubby he or she looks, he said.
Here are other reasons why your heart health may not look as good as your body.
YOU MAY HAVE YOUNG PEOPLE'S HEART PROBLEM
According to HealthXchange.sg, about 1,000 Singaporeans die from sudden cardiac death every year, half of whom are below the age of 60 – and that includes young people.
Good muscle tone is mainly a cosmetic quality and probably does not reflect (a person's) health status.
There is a difference between "cardiac arrest" and "heart attack". The former is triggered by an electrical malfunction in the heart that causes it to beat irregularly and it can occur at any age.
Meanwhile, a heart attack (known medically as acute myocardial infarction) "refers to a sudden blood clot occurring in one of the major arteries, resulting in heart muscle death," said Dr Lin Weiqin, consultant with the Department of Cardiology at National University Heart Centre, Singapore.
"Younger persons who appear slim and toned can have cardiac risk factors not immediately apparent to the untrained eye," said Dr Lin, who listed high blood pressure, high cholesterol, diabetes mellitus, genetics and smoking as risk factors.
But even without these risks, young individuals can still suffer from cardiac arrests. "There are some rare, inherited conditions which cause individuals to develop abnormal heart muscles (cardiomyopathy) or electrical conduction abnormalities in the heart," said Dr Lin, citing hypertrophic cardiomyopathy, dilated cardiomyopathy and Long QT Syndrome as examples.
He added: "Individuals with these conditions are predisposed to unstable and dangerous heart rhythms during periods of extreme physical exertion, which can lead to cardiac arrest. In fact, hypertrophic cardiomyopathy has been found to be a leading cause of sudden death in elite athletes".
Hypertrophic cardiomyopathy has been found to be a leading cause of sudden death in elite athletes.
Unfortunately, said Dr Ng, "these genetic heart diseases may not be apparent from the physical appearance, and can be detected only if they go for in-depth tests".
STRESS CAN 'BREAK' YOUR HEART
While there weren't any reports that Gao had cardiovascular issues prior to filming, he was said to have worked for 17 hours straight.
"During stress, hormones are produced which increase the risk of abnormal heart rhythms," said Dr Wong, who added that stress may also alter the way blood clots in the arteries and increase the risk of a heart attack.
"Extreme stress can also rarely be involved in a unique kind of heart attack, resulting in a weakened heart known as Takotsubo Syndrome or 'Broken Heart Syndrome'," he said.
Dr Ng added that being under emotional duress, such as depression and mood disorders, is another factor for increased risk of heart attacks.
THE FLU CAN CAUSE HEART INFLAMMATION
Gao was also said to be nursing the flu while filming the physically demanding variety show. Catching the flu may not seem like a big concern but the virus can cause inflammation of the heart, said Dr Ng.
Dr Wong said: "Depending on the severity of the inflammation, it can weaken the heart and cause heart failure. Or even result in sudden cardiac arrest due to electrical problem."