Published Nov 08, 2026 | 7:00 AM ⚊ Updated Nov 08, 2026 | 7:00 AM
A family history of unexplained sudden death, premature heart attacks or a known inherited heart condition should prompt medical evaluation.
Synopsis: The sudden deaths of a nine-year-old girl in Delhi and a 36-year-old marathon runner have raised concerns about hidden heart conditions in young people. Cardiologists explain the role of inherited heart disorders, electrical abnormalities and genetic mutations, while highlighting the importance of family screening, early diagnosis and emergency preparedness.
The sudden death of a nine-year-old girl who collapsed in a Delhi classroom and that of 36-year-old IBM engineer and trained marathon runner Kommineni Gopi after completing a race have raised questions about why apparently healthy young people can suffer sudden cardiac arrest.
The circumstances surrounding the two deaths do not, by themselves, establish what caused them. However, doctors say such incidents highlight a range of underlying heart conditions that can remain undetected for years and sometimes become apparent only during physical exertion or extreme stress.
These include inherited heart muscle disorders, electrical abnormalities, congenital defects in the coronary arteries and inflammation of the heart muscle. Some can be identified through family history, clinical evaluation and cardiac screening.
“When a young, fit person collapses suddenly, the first question is always ‘How could this happen?’ Many heart conditions stay silent for years and show up only under strain, such as hard exercise, fever or extreme stress,” said Dr Varun Bansal, Senior Consultant, Cardiothoracic and Vascular Surgery, Indraprastha Apollo Hospitals, New Delhi told South First.
Also Read: Sudden heart attack deaths now notifiable in Karnataka – a first for India
Sudden cardiac arrest occurs when the heart abruptly stops pumping blood effectively, usually because of an electrical disturbance that disrupts its rhythm. It is different from a heart attack, which occurs when blood flow to part of the heart muscle is blocked. A heart attack can trigger cardiac arrest, but the two are not interchangeable.
Dr Praneeth Polamuri, Senior Consultant Interventional Cardiologist at Yashoda Hospitals, Secunderabad, said many sudden cardiac deaths are associated with abnormalities in the heart muscle or its electrical system.
One important condition is hypertrophic cardiomyopathy (HCM), in which the heart muscle becomes abnormally thick, making it harder for the heart to pump blood. It is often linked to inherited genetic mutations. Many people with HCM have no obvious symptoms, while some experience breathlessness, palpitations, dizziness or fainting.
The risk of a dangerous rhythm disturbance can increase during strenuous exercise. An electrocardiogram (ECG) and echocardiogram, alongside clinical evaluation, can help identify the condition.
“Patients with hypertrophic cardiomyopathy have a very strong family-related condition. If a person in the family is diagnosed with hypertrophic cardiomyopathy, all first-degree relatives have to be screened for the presence of the condition,” Dr Polamuri told South First.
Other possible causes include arrhythmogenic cardiomyopathy, inherited electrical disorders such as Long QT syndrome and Brugada syndrome, and congenital abnormalities in the origin or course of coronary arteries. Myocarditis, or inflammation of the heart muscle, can also cause dangerous rhythm disturbances.
Dr Bansal also pointed to inherited conditions such as Marfan syndrome, which can cause enlargement of the aorta and, in severe cases, a life-threatening dissection.
Familial hypercholesterolaemia (FH) is another inherited condition that doctors say deserves attention. People with FH have very high cholesterol levels from birth, increasing their risk of premature coronary artery disease and heart attacks. The condition can remain unnoticed because it rarely causes symptoms.
“FH rarely causes symptoms, so many families do not know they have it. Inherited heart muscle conditions also run in families and often go unnoticed,” Dr Bansal said.
A family history of unexplained sudden death, premature heart attacks or a known inherited heart condition should prompt medical evaluation. Doctors particularly advise screening first-degree relatives, including parents, siblings and children, when an inherited heart muscle disorder is diagnosed.
Dr Polamuri said relatives of people diagnosed with HCM should undergo screening. Families that have experienced an unexplained sudden death should also seek medical evaluation rather than dismissing the incident as an isolated event.
“Any person in the family has a sudden unexplained death, all family members should be screened for possible hypertrophic cardiomyopathy. By early intervention, we can save a life,” he said.
Screening may involve an ECG, echocardiogram and, depending on the findings, longer-term rhythm monitoring, cardiac MRI or genetic testing. A normal initial test does not necessarily rule out an inherited condition, and doctors may recommend periodic follow-up for relatives.
Dr Bansal recommends checking cholesterol levels during childhood, particularly between the ages of nine and 11, and again in young adulthood. Testing may be considered earlier when there is a strong family history of premature heart disease. A one-time test for lipoprotein(a), or Lp(a), can also help identify an inherited risk factor for cardiovascular disease.
Genetic testing is most useful when there is a known inherited condition, a history of sudden cardiac death or premature heart attacks in the family. It should be accompanied by genetic counselling because a negative result does not eliminate every possible risk.
Researchers are increasingly examining the genetic basis of sudden cardiac death and inherited heart conditions.
Dr Vinod Scaria has highlighted the role of genetic factors in a significant proportion of sudden cardiac deaths. He has estimated that nearly one in five may have a definite genetic explanation, pointing to conditions such as cardiac channelopathies, cardiomyopathies and familial hypercholesterolaemia.
He has also called for molecular autopsies in unexplained deaths among young people. Such investigations can help identify an underlying genetic cause and allow relatives to undergo targeted screening.
“A genetic diagnosis may not bring someone back. But it could save a brother, sister, parent or child,” Dr Scaria said on X.
A Hyderabad-based study has added to the evidence on inherited heart muscle disease. Researchers from the CSIR-Centre for Cellular and Molecular Biology, Osmania University and AIG Hospitals analysed 160 patients with hypertrophic cardiomyopathy and 178 ethnically matched healthy controls.
The researchers identified two novel variants in the MYH7 gene, classified as likely pathogenic. The variants, p.Met684Arg and p.Leu725Pro, were observed in two families. In both, a parent diagnosed with HCM carried the variant, while an adult child also showed signs of the condition.
The study, published in the November issue of the Journal of the American College of Cardiology: Asia, found that the variants were absent from several major genetic databases and the healthy control group. However, the researchers acknowledged limitations, including the absence of functional experiments and the small number of families studied.
Dr Kumarasamy Thangaraj, Senior Scientist at CCMB, said genetic mutations can be present from birth even when a person has no visible symptoms. Identifying disease-associated mutations before structural changes emerge could help doctors monitor affected individuals and intervene earlier. Family members, particularly children carrying such mutations, may need continued monitoring.
Also Read: In 2024, 1 in every 3 medically certified heart attack deaths occurred in Tamil Nadu
Doctors say early recognition of warning signs and a prompt emergency response can make a difference. Fainting during exercise, unexplained chest pain, palpitations, breathlessness or dizziness should not be ignored, particularly when there is a family history of sudden cardiac death.
Dr Sudhir Kumar, a Hyderabad-based neurologist, has emphasised the need for schools to strengthen emergency preparedness. Teachers and support staff should receive basic life-support training, schools should have access to automated external defibrillators (AEDs), and institutions should conduct emergency response drills.
If a person collapses, is unresponsive and is not breathing normally or is only gasping, emergency services should be called immediately. CPR should be started while an AED is brought to the scene and used as soon as it becomes available.
The death of a trained marathon runner also underlines why fitness alone cannot be treated as a guarantee against underlying heart disease. A runner commenting on Gopi’s death said: “It is quite unfortunate and sad that a trained marathoner at a young age of 36 suffered cardiac arrest.”
The runner also cautioned against prioritising race performance over health: “You will have your personal best broken in some other race if this race did not go according to your plan, but we have only one life to live. Races can be run again for better performance, life can’t be rerun.”
Doctors stress that exercise remains important for cardiovascular health. However, unexplained symptoms, a family history of early heart disease or sudden death, and known inherited conditions warrant medical assessment before strenuous activity.
(Edited by Dese Gowda)
