SUNDAY BYTES: When the Heart Does Not Speak Heart Attacks in Young
Kashmir’s Silent Cardiac Emergency: Time to Investigate the Missing Links in Sudden Deaths in Young People
Dr. Fiaz Maqbool Fazili
Just days ago, a young man who appeared to be the very picture of health suddenly became a reminder of how unpredictable cardiac emergencies can be. He was young, apparently healthy, not obese, a non-smoker, and had no known family history of heart disease. He was not taking bodybuilding supplements or performance-enhancing substances. His only notable medical history was having had COVID-19 and receiving COVID vaccination. There was nothing obvious to suggest that he belonged to a high-risk cardiac group. Yet, suddenly, he developed a serious cardiac event. For his family, the question was immediate and frightening: how could this happen to someone who looked so healthy?
That question deserves something more than speculation. It deserves proper medical investigation, documentation and scientific inquiry—particularly when similar stories of young people collapsing or suffering cardiac events are increasingly being heard across Kashmir. One individual case cannot establish a cause, but it should make us ask whether we are adequately investigating the possible risk factors behind such events. My today’s piece is not another write up but a wakeup call on a disturbing rise in heart Attacks Among Youth! What Are We Failing to See? Why are so many young Kashmiri collapsing suddenly — And Why Are We Still Not Talking About It Seriously? A young doctor collapses unexpectedly. A teenager dies during a sports activity. A healthy-looking young man suddenly develops chest pain during a trek and never returns home. A student preparing for examinations suffers a fatal cardiac arrest, and a driver of a school bus collapses while driving. While working out at the gym, a fitness enthusiast suddenly collapsed. By the time help arrived, he was no more. These are no longer isolated tragedies whispered about in hospital corridors or mourned quietly inside grieving homes. They are becoming disturbingly familiar stories across India — and increasingly across Kashmir.
The frightening rise in sudden cardiac deaths and heart attacks among young adults has become a wake-up call that society can no longer afford to ignore. For generations, heart attacks were considered diseases of old age, linked to retirement, sedentary lifestyles, or decades of unhealthy habits. Today, however, cardiologists are witnessing heart disease striking people in their twenties, thirties, and forties — often without warning signs. Kashmir too stands at a dangerous crossroads. Behind our breathtaking mountains and serene landscapes lies a population increasingly burdened by stress, inactivity, hypertension, diabetes, obesity, smoking, poor sleep, processed food, anxiety, and unresolved trauma. The valley’s changing lifestyle patterns, combined with post-pandemic health concerns, are quietly shaping a cardiovascular disaster in slow motion. The question is no longer whether this problem exists. The real question is how many more young lives must we lose before we act collectively.
Social media timelines in Kashmir increasingly resemble obituary boards for young professionals, doctors, engineers, students, businessmen, and even athletes who died “suddenly.” Every unexplained death shocks society briefly, triggers speculation, emotional debates, and rumours, and then fades into silence without deeper scientific discussion. Many such deaths are casually labelled loosely as “heart attacks” without proper medical evaluation, post-event analysis, autopsy, or genetic screening. Yet experts worldwide warn that every sudden death is not necessarily a conventional heart attack. Some deaths occur due to inherited rhythm disorders, undiagnosed structural heart disease, myocarditis, electrical abnormalities, clotting disorders, or congenital cardiac defects that remain hidden until tragedy strikes. In Kashmir, this conversation remains emotionally sensitive and medically underexplored. Religious hesitation regarding post-mortem examinations, social stigma, lack of structured cardiac screening programs, and limited awareness often prevent proper diagnosis. Consequently, families remain unaware that surviving relatives may carry similar hidden risks. This is where Kashmir urgently needs a scientific, culturally sensitive, and ethically guided public health approach rather than denial, fear, myth, hearsay or speculation.
The reasons behind young hearts failing can be multiple, interconnected, and deeply rooted in modern life. Lifestyle has changed faster than human biology. Young people today move less and consume more unhealthy food than any previous generation. Fast food, processed meals, sugary beverages, excessive salt intake, smoking, and irregular eating patterns have become normalized. Physical activity has sharply declined. Many youths spend hours glued to screens, preparing for competitive examinations, working stressful jobs, or trapped in digital addiction. Sedentary behaviour silently damages metabolism and accelerates cardiovascular disease. Obesity, diabetes, and hypertension — once considered illnesses of middle age — are now appearing alarmingly early.
Stress has also become a permanent companion. Kashmir carries a unique emotional burden. Years of uncertainty, social instability, unemployment, economic pressure, educational competition, emotional insecurity, and psychological stress have deeply affected young minds. Chronic stress elevates cortisol and adrenaline levels, damages blood vessels, increases blood pressure, disturbs sleep, and strains the heart continuously. Many young people appear physically healthy while internally carrying enormous emotional exhaustion. Sleep deprivation further compounds the problem. A generation surviving on late-night scrolling, anxiety, irregular routines, and poor sleep hygiene is unknowingly damaging cardiovascular health.
Substance use is quietly fuelling the crisis. Smoking, vaping, nicotine products, stimulant drugs, alcohol misuse, and excessive energy drink consumption are increasingly common among youth. Energy drinks, often marketed as harmless performance boosters, can trigger dangerous arrhythmias, blood pressure spikes, and even sudden cardiac arrest in susceptible individuals. The culture of self-neglect disguised as a “modern lifestyle” is exacting a dangerous price.
One of the most debated and emotionally charged questions today is whether COVID-19 or vaccines are responsible for increasing heart attacks seen more frequently post covid among young people. Scientific evidence increasingly confirms that COVID-19 infection itself can significantly affect the cardiovascular system. Studies have shown that the virus may trigger inflammation of blood vessels, clot formation, myocarditis, plaque instability, and accelerated vascular ageing. Even mild infections may leave lingering cardiovascular effects for months or years. Researchers across the world have documented increased risks of heart attacks, strokes, palpitations, and chest pain following COVID infection. Repeated infections may further increase long-term cardiovascular risk. At the same time, health authorities worldwide maintain that severe cardiac complications from COVID infection are far more common and dangerous than rare vaccine-related myocarditis cases. The overwhelming scientific consensus continues to support vaccination benefits. However, what is genuinely needed is transparent research, honest public dialogue, and region-specific data rather than rumours, denial, politicization, or sensationalism. People deserve clarity, not confusion.
The possible causes proposed for the rising incidence of heart attacks among young adults are increasing due to a combination of obesity, diabetes, unhealthy lifestyles, substance abuse, stress, and poor sleep. Sedentary habits, processed diets, smoking, alcohol, stimulants, and excessive energy drink (gym protein) consumption are placing growing strain on the heart, while conditions like hypertension and early diabetes accelerate damage to blood vessels. Experts advise young people to regularly monitor blood pressure, cholesterol, and blood sugar levels, and adopt healthier lifestyles with better diet, exercise, sleep, not take any body building substance without supervision and stress management. Some young individuals who die suddenly may have had hidden genetic or congenital heart disorders all along. Conditions like hypertrophic cardiomyopathy, Long QT syndrome, Brugada syndrome, Wolff-Parkinson-White syndrome, congenital coronary artery anomalies, and inherited rhythm disorders may remain undetected until tragedy occurs. A fainting episode during exercise, unexplained palpitations, chest discomfort, sudden breathlessness, or a family history of sudden deaths should never be ignored. Yet in Kashmir, many families dismiss warning signs as stress, weakness, gastritis, or anxiety. This dangerous culture of ignoring symptoms must change urgently.
The debate regarding youth cardiac screening deserves serious attention. Countries like Italy demonstrated reduced sudden cardiac deaths among athletes after introducing ECG-based screening programs. While universal screening may not always be practical or cost-effective, targeted screening for high-risk groups can save lives. Kashmir must seriously consider ECG screening for competitive athletes, pre-participation cardiac evaluation in schools and colleges, screening for individuals with family history of sudden death, affordable cardiac camps in rural areas, awareness drives regarding warning symptoms, and availability of Automated External Defibrillators (AEDs) in sports arenas, basis CPR trainings at places of sports /Gym, schools, airports, colleges, and major institutions. A simple ECG or echocardiogram may sometimes identify life-threatening abnormalities before disaster occurs.
One of the biggest gaps in India — and especially in Kashmir — is the absence of reliable data. Without structured documentation, we continue functioning through assumptions, rumours, emotions, and fragmented narratives. A centralized registry documenting sudden deaths among youth could help identify patterns, risk factors, hereditary conditions, and preventable causes. This would allow cardiologists, electrophysiologists, genetic experts, public health authorities, and policymakers to formulate evidence-based preventive strategies. Kashmir’s leading medical institutions must collaborate rather than function in isolated silos.Perhaps the most sensitive issue is post-mortem evaluation. In Kashmir, post-mortems are generally associated with legal investigations, making families reluctant to consent except under compulsion. Religious concerns and emotional distress often discourage further examination after sudden deaths. But medicine has evolved. Today, minimally invasive or limited post-mortem techniques, including post-mortem CT imaging and targeted cardiac examination, can sometimes identify hereditary conditions without extensive procedures. This requires compassionate dialogue involving doctors, religious scholars, ethicists, and community leaders. The objective is not intrusion into grief but protection of surviving family members who may unknowingly carry similar risks. Saving future lives can itself become an act of collective responsibility.
This crisis cannot be solved only inside cath labs or ICUs. It requires societal transformation. Parents must encourage healthier eating and physical activity rather than glorifying endless academic pressure alone. Schools must prioritize physical fitness and emotional wellbeing. Mosques, community leaders, civil society groups, healthcare institutions, and media must spread awareness regarding preventive health.
Young people themselves must understand a harsh truth: no career, examination, social media status, or financial ambition is worth sacrificing health for. Stopping smoking and vaping, avoiding unnecessary stimulants and energy drinks, exercising regularly, sleeping adequately, controlling blood pressure and sugar, reducing processed food intake, managing stress actively, and seeking timely medical evaluation after persistent symptoms can save lives. Even small lifestyle corrections today may prevent catastrophe tomorrow.
A noted Kashmiri-origin electrophysiologist working in the United States recently lamented the increasing number of sudden deaths among young people and appealed to the medical fraternity of Kashmir to confront this issue collectively and scientifically. His words should echo across the valley.
This is not merely a medical issue. It is a social emergency, a public health challenge, and a moral responsibility. We cannot normalize young deaths by casually saying, “It was destiny.” Faith and preventive action are not opposites. Seeking knowledge, diagnosis, and prevention is also part of preserving life. Every unexplained young death leaves behind devastated parents, shattered spouses, traumatized children, and unanswered questions. Kashmir must not wait for this silent epidemic to grow further. The time has come for awareness, screening, research, preparedness, healthier living, and honest conversations free from fear, denial, or sensationalism.
A Tribute—and a Challenge for the Future: Young hearts are under attack
Ignoring the warning signs now would become our greatest collective failure. Yesterday, noted cardiologist Dr. Upendra Kaul released the second edition of When Heart Speaks, followed by a CME, rightly earning appreciation from the medical fraternity. His contribution extends beyond cardiology to building accessible, compassionate cardiac care. Through the Gauri Kaul Heart Center and his state-of-the-art facility in Pulwama, he has helped bridge the urban-rural divide, demonstrating that excellence matters only when it reaches those who need it. His vision offers Jammu and Kashmir a model of connected cardiac centres, saving lives, restoring hope, and serving humanity. But perhaps the next contribution could be even more important. As we increasingly encounter apparently healthy young people suffering serious cardiac events, could Dr. Kaul and colleagues consider leading a pilot research project titled “When the Heart Does Not Speak”? The question would be simple, but profound: When a young, apparently healthy person develops a major cardiac event or dies suddenly, where did things go wrong? Was it lifestyle? Stress? Sleep deprivation?
Hypertension or undiagnosed diabetes? Hidden genetic or structural heart disease? Previous infection? Inflammation? Substance or stimulant exposure? Something else—or a combination of several factors? We need to move beyond anecdotes, social-media speculation and assumptions. A structured registry of young cardiac events, with appropriate clinical evaluation, ECGs, imaging, laboratory investigations, family history, lifestyle assessment and, where ethically and legally appropriate, genetic or post-mortem evaluation, could begin to provide answers.
If “When Heart Speaks” teaches us to listen to the heart, perhaps “When the Heart Does Not Speak” can teach us to investigate its silence. Such a pilot project, led by our own cardiology fraternity and supported by Kashmir’s medical institutions, could become more than another study. It could become a young-lives-saving initiative—helping us understand the missing links, identify preventable risks and determine whether what we are witnessing is truly a changing pattern or simply a collection of tragic coincidences’. Kaul has already shown what one committed physician can build. Perhaps now he can help us discover why some young hearts fall silent before they ever have the chance to speak.
(STRAIGHT TALK COMMUNICATIONS EXCLUSIVE. Dr. Fiaz Maqbool Fazili is a former Hert surgeon at SKIMS, and Currently advocates as healthcare quality expert, reforms ,standards improvement and columnist who writes frequently on civic and social issues in Kashmir.)
