Sudden deaths under 45: Why 'healthy-looking' can be dangerously misleading

Sudden heart deaths in 'fit-looking' adults under 45 are often linked to silent coronary artery disease. An Apollo doctor explains why it hides, what raises risk, and what checks help

A young and fit person collapses, family and friends are stunned, and a familiar question follows: How could this happen to someone who looked so healthy? Recent headlines about sudden heart deaths among people under 45 have sparked fear and confusion.

 

According to Dr Sudhir Kumar, neurologist at Apollo Hospitals, Hyderabad, this phenomenon is not new at all. In fact, decades of research, including recent large Indian studies, show the same truth: heart disease has long been the leading cause of sudden death in young adults, often striking without warning.

 

Dr Kumar explains in a post shared on X that silent coronary artery disease can progress without any symptoms until it turns catastrophic. He stressed the need for prevention.

Is sudden heart death in young people really increasing, or just getting attention now?

Dr Kumar points out that studies from the 1990s and early 2000s already identified heart disease as the most common cause of sudden death in young adults. What has changed is data quality and visibility. Recent Indian studies, based on larger and more systematic datasets, have reconfirmed these findings and pushed them back into public conversation.

What does ‘appeared healthy’ mean in medical terms?

“Appeared healthy” does not mean disease-free. It usually means undiagnosed.

 

According to Dr Kumar, many young adults with coronary artery disease have no chest pain, no breathlessness, and no obvious red flags. Medical literature shows that conditions like silent myocardial ischaemia, where the heart doesn’t get enough blood but sends no pain signals, are common ways heart disease can show up clinically.

Can heart disease really stay silent for years in young adults?

Yes, and that’s what makes it dangerous. Plaque can slowly build up in arteries, blood pressure can creep up, and blood sugar or cholesterol can drift out of range without causing day-to-day discomfort. Long work hours, chronic stress, poor sleep, smoking, processed foods, and physical inactivity quietly accelerate this damage.

 

By the time symptoms appear, the disease may already be advanced. Waiting to “feel something wrong” gives heart disease a long head start.

Which risk factors matter most for people under 45?

Dr Kumar highlights several risks that deserve attention early: family history of heart disease, smoking, diabetes, abnormal cholesterol, obesity, especially abdominal fat, chronic stress, and a sedentary lifestyle. When these overlap, the overall danger multiplies.

 

Looking slim or being young does not cancel out these risks. 

Which health checks can catch hidden heart risks early?

Simple tests can reveal problems long before symptoms start:

• blood pressure
• fasting blood sugar
• HbA1c
• cholesterol levels
• kidney function tests
• waist circumference

Doctors may also recommend ECGs or imaging when needed.

 

According to doctors, catching risk factors early allows for simpler and more effective interventions that are often lifestyle-based, rather than emergency treatment after a crisis. 

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This content is for informational purposes only and is not a substitute for professional medical advice.