Sudden Deaths in Young Indians Linked Mostly to Heart Disease

Study Calls for Recognition of Sudden Death in Young Adults as a Public Health Issue

December 20, 2025

A new research has found that a significant number of young adults in India are dying suddenly, most often due to undetected heart disease, even though many appear healthy and have no known medical conditions. What is concerning is that these deaths frequently occur at home or during routine activities, and in a large share of cases, even detailed autopsies fail to identify a clear cause, leaving families without answers and risks unaddressed.

The study, backed by the Indian Council of Medical Research (ICMR), found that nearly 1 in 20 autopsies at a major Delhi hospital involved young adults who died suddenly. Most of these deaths were linked to heart disease, especially among men in their 30s. Published in the Indian Journal of Medical Research, the study looked at sudden deaths, meaning people who died within an hour of feeling unwell or within a day of being last seen alive.

Heart-related causes made up 42.6 percent of all sudden deaths in young adults. Of these, 85 percent were due to coronary artery disease (CAD), a condition where the arteries that supply blood to the heart become narrowed or blocked. Most of the victims were men in their 30s. Autopsies showed severe blockages, mainly in the left anterior descending (LAD) artery, along with signs of heart muscle damage caused by reduced blood flow. Many of those who died were regular smokers and alcohol users.

Lung-related illnesses were the second most common cause of sudden death in young adults, accounting for 21.3 percent of cases. These included asphyxia caused by inhaling vomit into the lungs, serious forms of pneumonia and tuberculosis. Most of the asphyxia cases were seen in people who regularly consumed alcohol. In tuberculosis cases, the infection had spread widely through the lungs, causing severe damage.

In another 21.3 percent of cases, doctors could not find any clear cause of death even after full internal examination. These were classified as sudden unexplained deaths. Most of the people in this group were again men in their 30s. Some had small issues like minor heart muscle damage or early-stage artery buildup, but nothing serious enough to explain why they died.

A smaller number of deaths were caused by problems in the stomach and intestines, including severe pancreatitis linked to alcohol use, tuberculosis in the intestines, and heavy bleeding in the upper digestive tract. Some deaths were due to bleeding in the brain or rare conditions like brain cysts. A few cases involved complications in the reproductive system, such as a ruptured ectopic pregnancy or a torn uterus.

Only a small number of the young adults who died had documented comorbidities, meaning long-term health conditions that could contribute to risk. Just 3.2 percent had diabetes and 5.3 percent had high blood pressure, both of which were far more common in the older group studied.

Men accounted for 82 percent of young sudden death cases, with most deaths occurring at home, during sleep or while traveling. Nearly 40 percent of deaths happened at night or early morning. The most common reported symptom before death was sudden loss of consciousness, followed by chest pain, breathlessness or gastrointestinal discomfort. The number of sudden deaths stayed fairly consistent across all seasons and days of the week, with no major pattern or spike observed.

The study found that smoking and alcohol use were widespread among those who died suddenly, with more than half of the young victims being regular users. Most of the deaths were among people from lower or middle-income backgrounds, working in a mix of skilled, unskilled, and semi-professional jobs.

Most of the young and older adults in the study had received the COVID-19 vaccine, but there was no clear link between vaccination or past infection and sudden death.

Investigators noted that despite advanced techniques used to determine cause of death, a significant proportion of cases remained unexplained. They called for greater use of genetic testing in such cases to detect inherited cardiac conditions that do not leave visible traces during autopsy.

The authors called for recognition of  sudden death in young adults as a public health issue in India, recommending more extensive regional studies, wider use of forensic and molecular diagnostic tools and better screening to identify people at risk.

They also warned that current death certification practices in India often omit postmortem investigations, resulting in the true incidence of sudden death being underestimated.

Doctors recommend that young Indians undergo early cardiovascular screening if they have a family history of sudden death or experience unexplained fainting, chest discomfort or shortness of breath. Lifestyle changes such as quitting smoking, reducing alcohol consumption and managing stress and diet are also critical in lowering risk.

Public health experts say schools, colleges and workplaces should train staff in CPR and basic emergency response and install automated defibrillators in public areas where feasible. Early response in cases of cardiac arrest significantly improves survival.

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