In a country where fitness is finally finding its place in everyday life, headlines about young, seemingly healthy individuals collapsing during a workout or mid-marathon have become alarmingly frequent. What was once a cause for celebration, India’s growing awareness of exercise, is now sharing space with uneasy questions. How can people who look fit, follow training regimens, and post #healthyliving content suddenly suffer a cardiac arrest?
The answer isn’t simple. But it often begins with what we don’t see, what even the person may not be aware of about their own heart. We spoke to Dr Johann Christopher, Consultant - Interventional Cardiology, CARE Hospitals, Banjara Hills, Hyderabad, who explained that without screening the heart, even the fittest bodies can face the deadliest risks.
The Silent Risks Beneath the Surface
Cardiac arrest and heart attack are distinct conditions, with cardiac arrest being a sudden electrical failure that causes the heart to stop beating. “While it can happen due to known heart disease, in younger adults, it’s often triggered by previously undetected structural or electrical abnormalities. This may include conditions, such as Hypertrophic Cardiomyopathy (HCM), Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC), or congenital conduction system disorders,” explained Dr Christopher.
Recent India-specific data points to a disturbing rise in sudden cardiac deaths in individuals under 40, even among those without typical risk factors like diabetes or hypertension, according to the International Journal of Cardiology Sciences.
These don’t always show up in a basic health check. And in the pursuit of physical goals, many ignore early signs; fatigue that seems 'normal,' occasional palpitations, or shortness of breath that’s brushed off as poor conditioning. By the time symptoms are recognised, the body is already on edge.
“In many cases, these underlying issues remain dormant until pushed to a threshold, usually during a moment of physical or emotional strain. That strain can come from sprinting the last mile, lifting heavier than usual, or even exercising in extreme heat,” added Dr Christopher.
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Training the Body, But Not the Heart
Urban India’s fitness revolution is largely self-driven. The shift is visible, from running clubs and CrossFit boxes to HIIT routines streamed on smartphones. However, while training protocols are freely shared, cardiac safety often isn’t part of the conversation.
The focus tends to be on strength, fat loss, and performance metrics, rarely on internal markers of cardiovascular resilience. Instructors, while passionate, may not always have medical awareness, and clients often hesitate to speak up about discomfort, fearing it might seem like weakness.
“Many first-time gym-goers and marathon aspirants jump into intense routines without a cardiac evaluation. Add factors like long working hours, inadequate sleep, stimulant use (including some pre-workout supplements), and poorly guided dieting, and the body enters a stress cycle. The heart, if vulnerable, may not cope, said Dr Christopher.
What’s more, even those who look lean and fit may still be at risk. South Asians carry a higher genetic tendency toward coronary artery disease, and this risk doesn’t always correlate with visible fitness.
What Should We Be Checking?
“A 'fit to run' certificate isn’t enough. For those over 35, or anyone with a family history of heart disease, more detailed evaluations can be life-saving. Tests, including ECGs, echocardiograms, treadmill stress tests, and, in some cases, cardiac MRIs or coronary calcium scoring, provide a better picture of cardiac health,” advised Dr Christopher.
Equally important is understanding personal thresholds. Fitness is individual. What works for one person may overstress another. There’s no harm in starting slowly, building endurance mindfully, and listening when the body says stop.
Also Read: Heart Attack Vs Heart Failure Vs Cardiac Arrest: Know The Key Differences Between The Three
Awareness, Not Alarm
“The solution isn’t to stop exercising. It’s to stop assuming that youth or appearance equals immunity. Preventive cardiac screenings, awareness of warning signs, and basic CPR training at gyms and event venues can go a long way in saving lives,” suggested Dr Christopher.
Even small steps, such as asking for a basic cardiac check before starting a new regimen, can make a difference. Education for trainers, staff, and fitness communities could bridge the gap between performance and safety.
When singer KK collapsed after a concert, and when young runners in Indian marathons failed to cross the finish line alive, the nation mourned. But mourning without change means we will be back at the same question next month, next season.
It’s Time to Rethink What Being ‘Fit’ Means
Dr Christopher concluded, “True fitness isn’t just about speed, endurance, or visible muscle. It’s about sustainability. It’s about knowing your body, not just sculpting it. As India gets faster and fitter, the heart has to be part of the plan. Not as an afterthought, but as the first step.”
[Disclaimer: This article contains information provided by an expert and is for informational purposes only. Hence, we advise you to consult your professional if you are dealing with any health issue to avoid complications.]