Is there a reason why cardiac arrests often happen in the bathroom?

Many people want to prioritise heart health, but have limited knowledge about the signs and symptoms that indicate an unhealthy heart. This World Hypertension Day, Dr Nityanand Tripathi, the director and unit head — cardiology and electrophysiology at Fortis Hospital, Shalimar Bagh throws light on an important topic: the disproportionately-high rate of heart attacks and cardiac arrests in the bathroom.
Is there any truth to it, and if so, why does it happen?
According to the doctor, one first needs to understand what a cardiac arrest is. It is a condition where the heart stops beating, and when it happens, essential organs no longer get oxygenated blood, leading to collapse and loss of life. “A heart attack, on the other hand, is a condition wherein a part of the heart stops getting oxygenated blood because of sudden clot formation in a blood vessel supplying blood to that part of the heart. Both are life-threatening,” he explains.

Dr Tripathi adds that most people spend an average 30 minutes or 2 per cent of their time per day in the toilet. But, it seems to be the place where heart attack and cardiac arrests happen at a disproportionately-high frequency, of 8 to 11 per cent, he says.
Since bathrooms are private places, detection and resuscitation are always delayed, and outcomes are, therefore, poor. The frequency of collapse is 8 per cent, and the chances of revival a dismal 13 per cent, he mentions.
According to the expert, the most common cause of heart attack and sudden cardiac death in the toilet is a consequence of defecation/micturition syncope. “There is a decrease in blood pressure during straining because of an imbalance between the sympathetic and parasympathetic autonomic nervous system; this leads to a decrease in blood flow to the brain and loss of consciousness. These events may also lead to a sudden surge in blood pressure, heart attacks, and sudden cardiac arrest in the toilet and bathroom,” he explains.
Taking a bath in water that is too cold can lead to blood flow from all sides towards the head, increasing the stress on arteries and capillaries. (Photo: Getty/Thinkstock)
The other causes, he says, may be rushing to the toilet after feeling sick, nausea/vomiting, and collapsing.
“Taking a shower — either too cold or too hot — can impact heart rate, blood pressure, and dribution of blood flow. Taking a bath in water that is too cold can lead to blood flow from all sides towards the head, increasing the stress on arteries and capillaries, which may cause cardiac events.”

Some things to keep in mind, according to Dr Tripathi:
* One must not strain too much during defecation or passing urine. Take your time while getting relieved.* Avoid water that is too hot or too cold. Do not start pouring water directly on the head; start washing the feet or shoulder and gradually move up.* Avoid getting exposed to a cold environment in the bathroom/toilet, especially in winters, as it may trigger a heart attack.* If you fall in the vulnerable group, having had a previous heart attack, angina, old age, your heart pumping power is weak, you have had a stroke or multiple comorbidities, it is wise to not lock the door while using the toilet/bathroom.* Toilets/bathrooms used the vulnerable should have alarms handy, so that help can come in time.
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