Pepperfry co-founder Ambareesh Murthy dies in Leh: What triggers cardiac arrest at high altitude?

The untimely demise of Ambareesh Murthy, co-founder of Pepperfry, due to a sudden cardiac arrest (SCA), raises concerns about the escalating incidence of such events even among physically fit individuals. Despite being recognized as an experienced biker, having embarked on journeys to challenging terrains like Leh, questions emerge regarding the vulnerability of young, active Indians to cardiac arrests.

The puzzlement arises from the fact that individuals beyond their 40s rarely undergo heart assessments to gauge their condition\’s adaptability to unfamiliar physical activities or various stressors. The trigger for sudden cardiac arrest can stem from factors such as reduced ambient oxygen levels in harsh environments, particularly for those with pre-existing heart conditions or underlying health issues. While Ambareesh Murthy\’s heart health details remain undisclosed, except his affinity for biking, the risks are compounded when taking a direct flight to Leh instead of a road journey. In certain cases, altitude-induced physiological complications like High Altitude Pulmonary Edema can escalate to hypoxia, leading to sudden cardiac arrest. To counteract this, medical professionals recommend commencing a course of the diuretic Diamox at least a week prior to the intended journey to mitigate fluid retention and potential edema-related risks.

Dr. Nishith Chandra, Principal Director of Interventional Cardiology at Fortis Escorts Heart Institute in Delhi, emphasizes that participating in strenuous sports like cross-country biking and trekking without a grasp of underlying health conditions can be perilous. The intense physical exertion and potential stress associated with endurance activities heighten the likelihood of sudden cardiac arrest. Notably, studies have revealed that extreme sports, like professional cycling, can induce changes in and harm the heart. Dr. James O’Keefe\’s 2012 study in the Mayo Clinic Proceedings revealed how endurance sports could lead to permanent heart muscle overstretching, resulting in excessive strain on the heart. The research, albeit conducted with a limited sample of 40 marathon runners, triathletes, and cyclists, detected scarring in the right heart chamber of five athletes. Strikingly athletic subjects displayed a higher tendency for coronary artery calcification compared to those with no history of physical activity. Hence, it becomes imperative to undergo comprehensive medical evaluations and adhere to safety protocols to curtail these risks, Dr. Chandra underscores.

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