Senior cardiologist Dr Prakash Raj Regmi has called attributing death of CPN (Maoist Center) Chairman Pushpa Kamal Dahal's son Prakash to sudden cardiac arrest without an autopsy irresponsible.
"What he died of could not be determined," Dr Regmi says. "And the way for finding it has been ended forever now that his body has been cremated." One may associate a death due to stopping of heartbeat to heart. But everybody dies after stopping of heartbeat, according to him, and why his heartbeat stopped could not be found.
"Sudden cardiac arrest can be one of the many reasons behind stopping of heartbeat," he states. "But attributing the death to sudden cardiac arrest without an autopsy is immature."
He concedes that deaths of youths of Prakash's age-group, mid-30s, and even younger have been rising in recent times. He reveals that around four persons below 50 arrive at the Shahid Gangalal National Heart Center on an average every day for emergency care and half of them die. "Heart attack does not happen suddenly. Some precursors must be visible before that," he adds.
There can be other reasons behind such sudden stopping of heartbeat, he points. "He may have suffered a big brain hemorrhage due to excessive drinking and sudden surge of blood pressure," he says. "Many Nepalis going for foreign employment die similarly while sleeping during the night and there may be various reasons," he argues.
But everyone calls it sudden cardiac arrest or heart attack as it is easy to do that and people easily believe as the term is in vogue. This also easily hides the real reason of deaths. "Post mortem was a must in this case," he claims. "Medical science would also have benefitted by knowing how such a young person died suddenly."
He adds that an autopsy is mandatory in such cases in other countries. There can be Brugada syndrome, a genetic condition, in some cases which results in abnormal electrical activity within the heart, increasing the risk of sudden cardiac death. Their heartbeat is affected in a way that can lead to death even due to sudden emotions or a little excess alcohol intake. "There is a higher chance of people dying from that than even heart attack," he states.
A look at the heart while doing post-mortem would have immediately showed whether it was sudden cardiac arrest or heart attack. The brain could have been opened if there was no problem in the heart, he states. "Hemorrhage there would have revealed he died of brain stroke," he says.
Biochemical tests of vascular tissues and blood would have revealed the reasons behind the stroke. It would also have revealed if the death was due to overdose of any prescription drugs. The death may also have been due to sudden damage of the aorta resulting in internal bleeding.
"Post mortem, that could have revealed numerous such reasons, was not done," he rues. "They chose the easier option of calling it sudden cardiac arrest."
