19th Feb, 25 15:26 IST

A 23-year-old woman recently collapsed mid-dance at a wedding in Madhya Pradesh, dying of sudden cardiac arrest. With no prior health issues, her death echoes rising cases of unexplained heart failures in young adults, sparking urgent calls for cardiac screening and awareness.

A viral video from a sangeet ceremony in Vidisha, a town in Madhya Pradesh known for its historical significance, has left viewers in disbelief. In the clip, 23-year-old Parinita Jain, full of life and energy, takes the stage, dancing to the popular Bollywood song 'Sharara Sharara'. Just 30 seconds into her performance, the MBA graduate from Indore suddenly stumbles forward slightly, and then collapses onto the floor. Initially, guests at her cousin's wedding thought she had merely lost her balance or fainted due to exhaustion or dehydration. However, as she lay motionless, panic ensued.

Family members are seen rushing to her side, shaking her in an attempt to revive her, while others call out for help. Despite frantic efforts, she remained unresponsive. She was immediately transported to a nearby hospital, where doctors declared that she had suffered a fatal heart attack.

Medical professionals at the hospital confirmed that Parinita was unresponsive upon arrival, showing no pulse or signs of breathing. Despite immediate and extensive resuscitation attempts, including advanced cardiac life support (ACLS), she could not be revived. An electrocardiogram (ECG) revealed no detectable electrical activity in her heart, confirming that she had succumbed to sudden cardiac arrest.

Parinita's death is especially unsettling because it seemingly occurred without warning. A week before the incident, she had reportedly visited a doctor for hair loss and undergone routine blood tests. Her results were completely normal. Her family is now grappling with unbearable grief, made worse by the eerie parallel to a tragedy they endured in 2009 her twin brother, at just 7 years old, also suffered a sudden cardiac arrest while riding his bicycle. His death had remained a mystery, with no prior symptoms or indications of an underlying health condition. Now, more than a decade later, the family finds itself facing the same devastating loss.

Given their tragic history, experts suggest that the family could have undergone genetic screening or cardiac evaluations to check for hereditary conditions that might predispose them to sudden cardiac events. While such tests are not always routine, they can sometimes provide early warnings in cases like these.

Her father, Surendra Jain, struggling to process what has happened, spoke to media persons about his daughter's vibrant spirit. "She was full of life..." he said. More surprisingly, Parinita was highly health-conscious - she practised yoga regularly, followed a disciplined fitness routine, and was careful about her diet and overall well-being. There had also been no signs of any health issues, which has made her sudden death all the more shocking.

Parinita's case is a stark reminder of a growing but poorly understood phenomenon: sudden cardiac arrest (SCA) in young, otherwise healthy individuals. Experts believe that such cases are often triggered by undiagnosed heart conditions that remain silent until a crisis moment.

Unlike traditional heart attacks that are caused by blocked arteries, sudden cardiac arrest is an electrical malfunction of the heart that causes it to stop beating within moments. There is usually no warning no chest pain, no shortness of breath just a sudden collapse that can be fatal within minutes if immediate medical intervention is not available.

No danger signs

Dr Pravin Kahale, consultant cardiologist at Kokilaben Dhirubhai Ambani Hospital, Mumbai, explains that SCA in young adults can be linked to structural heart diseases, electrical disorders, and vascular anomalies.

Hypertrophic cardiomyopathy (HCM), one of the most common inherited heart conditions, causes the heart muscle to thicken, making it difficult to pump blood efficiently. Another possible culprit is Long QT syndrome, an electrical disorder that disrupts the heart's normal rhythm, increasing the risk of sudden arrhythmias and cardiac arrest.

"Such conditions often go unnoticed because they may not present any symptoms until a fatal event occurs," says Dr Kahale. "Genetic factors can play a role, and individuals with a family history of unexplained sudden deaths should undergo cardiac screening."

Parinita's case raises concerns about whether intense physical exertion, such as dancing, can trigger a cardiac episode in those with underlying conditions. Dr Praveen Kulkarni, senior consultant cardiologist at Gleneagles Hospital, Mumbai, believes it is entirely possible. "Unexpected physical exertion can trigger latent heart conditions in individuals who are otherwise undiagnosed.

The heart races with exercise and demands more oxygen. If there is an undetected issue, this can lead to fatal arrhythmias or cardiac arrest," he explains.

What makes Parinita's case stand out from regular heart incidents is the absence of common risk factors. Unlike cases where heart attacks are linked to high cholesterol, obesity, or lifestyle choices, Parinita showed no warning signs. Unlike older patients, where plaque buildup in arteries is often a leading cause, her case suggests a possible underlying congenital condition.

Her death is in some way similar to that of Arjun Deshmukh, a 20-year-old state-level badminton player who collapsed mid-match during last year's Maharashtra state championship at Shiv Chhatrapati Sports Complex, Pune. Competing in the quarterfinals, Arjun had just finished a gruelling rally when he suddenly stumbled and fell. Initially, spectators and officials assumed he had simply lost his balance due to exhaustion. But within moments, it became clear something was terribly wrong he was motionless and unresponsive.

Coaches and medical staff rushed in, performing CPR (cardiopulmonary resuscitation), but despite their efforts, Arjun was declared dead on arrival at Sassoon General Hospital, Pune. His sudden passing sent shockwaves through the sports community.

An autopsy and genetic testing later revealed he had arrhythmogenic right ventricular dysplasia (ARVD) a rare, inherited heart disorder that silently replaces normal heart tissue with fibrofatty deposits, disrupting electrical signals and triggering fatal arrhythmias during intense physical exertion. ARVD often remains undiagnosed until sudden cardiac arrest occurs, making it one of the leading causes of athlete deaths. Devastated by the loss, Arjun's family underwent genetic screening, which revealedthat his younger sibling also carried the ARVD mutation. Unlike Arjun, this sibling had no symptoms yet, but early detection allowed them to take preventive measures, including avoiding high-risk sports and undergoing regular cardiac monitoring.

The tragedy reignited calls for mandatory pre-competition ECG screenings in Indian sports, particularly for young athletes in athletes in high-intensity disciplines. In contrast to countries like Italy, where routine cardiac testing has significantly reduced sudden athlete deaths, India still lacks standardised heart screenings for state and national-level players.

Common causes of sudden cardiac events :

-Hypertrophic cardiomyopathy: A genetic disorder where the heart muscle thickens, making it harder for the heart to pump blood efficiently.

-Dilated cardiomyopathy: The left ventricle enlarges and weakens, reducing the heart's ability to circulate blood effectively.

-Arrhythmogenic right ventricular dysplasia: Fatty or fibrous tissue replaces heart muscle, disrupting electrical signals and increasing the risk of fatal arrhythmias.

-Long QT syndrome: A disorder that affects the heart's electrical activity, making it more prone to dangerous arrhythmias and sudden cardiac arrest.

-Brugada syndrome: A genetic condition affecting sodium channels, leading to abnormal heart rhythms and a heightened risk of sudden cardiac death.

-Congenital coronary anomalies: Structural abnormalities in the coronary arteries can restrict blood supply, especially during intense physical exertion.

-Other contributing factors

# Myocarditis: Inflammation of the heart muscle, often caused by viral infections.

# Electrolyte imbalances: Irregular levels of key minerals (such as potassium and magnesium) can disrupt heart function.

# Substance abuse: Stimulants, energy drinks, or drugs can trigger arrhythmias and increase the risk of cardiac events.

A worrying trend

The growing number of sudden cardiac deaths among young people is alarming health experts. Dr Haresh G Mehta, director of interventional & structural cardiology at SL Raheja Hospital, Mumbai, highlights that such cases are no longer as rare as they once were.

"One in every five heart attack patients today is under the age of 40. Rising cases of diabetes, hypertension, obesity, stress, and sedentary lifestyles are playing a major role in this troubling trend," he says.

A study published in the European Heart Journal states that sudden cardiac arrest accounts for 10-12% of deaths in individuals under 35, with 80% of these victims having no prior diagnosis of heart disease.

While Parinita and Arjun's cases are unique due to the lack of prior symptoms, other young individuals have also suffered similar fates. For instance, at just 28, Keshav Jha, a chartered accountant, suffered a massive heart attack. Unlike Parinita, Keshav had multiple risk factors - he was overweight, had high blood pressure, and had lived with diabetes since childhood.

"These underlying conditions had caused severe blockages in his coronary arteries, restricting blood flow to his heart," said Dr Swarup Pal, senior consultant cardiovascular and thoracic surgeon at Gleneagles Hospital, Mumbai. Keshav ultimately had to undergo coronary bypass surgery to restore proper blood circulation.

Another case involved a 25-year-old IT professional who suffered a heart attack while at home. His lifestyle was a major factor long working hours, excessive stress, lack of sleep, and heavy alcohol and tobacco consumption all took a toll on his heart.

"The night before his heart attack, he had experienced mild chest pain and discomfort, which he ignored. The next morning, he collapsed. Fortunately, immediate medical intervention, including clot-busting medication and angioplasty, saved his life," added Dr Pal.

Recommended cardiac screening tests for athletes

-Electrocardiogram (ECG): A baseline test that detects electrical abnormalities and irregular heart rhythms.

-Echocardiography (Echo): Ultrasound imaging of the heart to assess structural abnormalities and overall function.

-Stress/treadmill test: Evaluates how the heart responds to physical exertion, identifying hidden cardiac issues.

-Genetic testing: Recommended if there is a family history of sudden cardiac death or inherited heart conditions.

-Holter monitoring: A 24-hour ECG that continuously records heart activity to detect intermittent arrhythmias.

What can one do?

Parinita's death underscores the importance of early detection and awareness of hidden heart conditions. Experts strongly recommend regular heart screenings for young adults, especially those with a family history of heart disease. The American Heart Association has introduced a 14-element checklist to screen for cardiac risk, assessing factors such as family history, exertional chest pain, and unexplained fainting. If symptoms or risk factors are identified, additional tests such as ECG, echocardiograms, and genetic testing may be necessary.

In cases like Parinita's, where cardiac arrest happens suddenly, CPR can be a lifesaving intervention. Dr Mehta stresses the importance of immediate bystander CPR, which can significantly increase survival chances. "CPR keeps oxygenated blood flowing to the brain and other vital organs, delaying tissue death. Without CPR, brain damage is likely within five minutes, and death becomes almost certain after eight minutes," he warns.

Here are the immediate steps bystanders should take if someone collapses suddenly.                                

Parinita Jain's tragic and untimely death leaves many questions unanswered, but it highlights the pressing need for greater awareness, proactive cardiac health screenings, and rapid emergency response training. Could her life have been saved with earlier detection of an underlying condition? It's a question that lingers, with sudden, unexplained cardiac deaths among the young.