chennai a 348kg man from assam who was going home nearly 10 days after a weightloss surgery in a city hospital died in a train at a railway station in assam on friday doctors here suspect he may have suffered a heart attack due to the strain of the long journey sanjay dey 28 who had been rejected by several hospitals before coming to chennai underwent a robotic bariatric surgery at apollo hospitals on april 30 doctors who operated on him had told him that he was at risk of heart attacks and strokes with or without surgery obesity can cause a series of problems including heart attacks even after the surgery dey was at risk because it would take months before he would lose a considerable amount of weight said his surgeon dr rajkumar palaniappan doctors say dey was one of the heaviest patients in asia to undergo bariatric surgery they reduced his stomach into a small pouch the patient was advised not to travel by train after the surgery as it could be stressful we gave a letter of reference to travel by air he said reports from assam said dey who had boarded the guwahatibound ernakulam express suffered a heart attack near barpeta road station at rangiya station 20 porters took more than four hours to get the body off the train dey was accompanied by his brother tapan the family members could not be contacted doctors say it could be challenging to evaluate risk factors for obese patients ahead of surgeries because they often have unique complaints for instance most morbidly obese people complain of breathlessness and chest discomfort that could be a sign of a heart problem or just a symptom of obesity morbid or severe obesity is a term used on people whose body mass index is higher than 40 in deys case it was more than 100 he hadnt got out of bed for several months said dr palaniappan before bariatric surgeries doctors evaluate age gender cardio respiratory fitness and electrolyte disorders doctors said dey was checked into the hospital nearly a week before the surgery despite all this we lost the patient said dr palaniappan