What's causing sudden death in youngsters? Postmortem expert's analysis

Each time we hear of a young person collapsing on stage while dancing or falling lifeless during a game of badminton, the first question that strikes us is ‘How so young.’ Doctors, however, note that many of these deaths occur because early warning signs from the body are often ignored.

Unhealthy eating habits, lack of regular exercise, mental stress, and inadequate sleep can all contribute to myocardial infarction (heart attack). Family history is another important factor. Since immunity and resilience are generally higher among youngsters, they often overlook or dismiss symptoms that should not be ignored.

A study conducted by the ICMR–National Institute of Epidemiology highlights that individuals who were hospitalised due to COVID infection, or who have a family history of sudden deaths, need to be especially cautious. Overexertion, heavy alcohol consumption within 48 hours or the use of narcotics also significantly increase the risk of abrupt death.

What the postmortem table tells us
The first person to determine the exact cause of death is often the surgeon conducting the postmortem. According to Dr TM Manoj, Assistant Professor at Kasaragod Medical College and Assistant Police Surgeon, the closure of arteries in the heart is a leading cause of sudden deaths among the young.

Among healthy individuals aged 20 to 50, even if a major artery becomes blocked, the heart can continue functioning with the help of smaller veins. However, such people are at risk of dying during their first or second cardiac arrest.

Others suffer from cardiomyopathy, a condition where the heart muscles are weakened. Even if they exercise regularly, a lack of warm-up or sudden exertion such as sprinting up a flight of stairs can trigger a fatal heart attack.

In some cases, arteries may close temporarily and later reopen after a cardiac arrest, leaving no visible blockages during postmortem. People with a genetic predisposition to heart disease are at higher risk of artery blockages and may develop coronary artery thrombosis. Dr Manoj notes that even those as young as 20 or 21 have been found to collapse from such conditions.

Post-COVID, cases of arterial blockages in the heart, lungs, and brain have been observed more frequently. The use of narcotics can cause a sudden spike in blood pressure, leading to ruptured arteries in the heart or brain, which is another cause of death seen during autopsies.