Fit Enough To Run. Is Your Heart Safe

Fitness is not a guarantee of cardiac health. Even apparently healthy runners can harbour undiagnosed cardiovascular conditions that may become evident during intense exertion, warns Dr B. Soma Raju, cardiologist, medical innovator and former Chairman of CARE Hospitals, who serves as Consultant Cardiologist and Mentor Director at Sindhu Hospitals.

Gopi’s death follows other tragedies at Indian running events: 25-year-old Aryan Todi collapsed at the Indore Marathon in February 2026, while 31-year-old Amandeep Singh Jagade died after collapsing at the Nandi Hills Monsoon Marathon in August. The 2024 Tata Mumbai Marathon also saw two participants, aged 40 and 74, die. These deaths spotlight silent cardiac risks, screening gaps and emergency preparedness. Stamina can take a runner to the finish line, but it cannot guarantee a healthy heart.

THE FITNESS PARADOX

Strong muscles. Good stamina. But what about the heart? Silent coronary artery disease, hypertrophic cardiomyopathy and inherited heart conditions can go undetected, even in apparently fit individuals. “As both a runner and a doctor, I would never want to confuse endurance with immunity,” says Dr Chandra Shekar Ramineni, orthopaedic surgeon and marathoner. “We train our muscles, monitor our pace and improve our stamina, but we must also pay attention to the heart that makes it all possible.” Dr BVA Ranga Reddy, Senior Consultant Cardiologist, Apollo Hospitals, reinforces the warning, “Fitness alone does not guarantee a healthy heart. Family history, diabetes, high blood pressure, high cholesterol and smoking can raise cardiac risk, even among regular exercisers.”

HEART ATTACK OR CARDIAC ARREST?

“It is important to distinguish between a heart attack and sudden cardiac arrest. A heart attack is usually caused by blockage of blood supply to the heart muscle, whereas cardiac arrest is the sudden loss of effective heart function, often due to a dangerous electrical rhythm. A heart attack can sometimes trigger cardiac arrest,” explains Dr Ramineni.

Dr Ranga Reddy highlights the importance of recognising underlying cardiac risks rather than assuming that an apparently fit person is free from them. The precise cause of Gopi’s death should not be inferred from the circumstances alone; it requires medical confirmation.

KNOW YOUR RISKS

Family history of premature heart disease or unexplained sudden death, diabetes, high blood pressure, high cholesterol, obesity and smoking can increase cardiovascular risk.

Dr Ranga Reddy warns that these risk factors can matter even in people who exercise regularly. Dr Ramineni also stresses that undiagnosed conditions may remain hidden until intense physical exertion.

BEFORE YOU CHASE THE NEXT PERSONAL BEST

“Recreational runners should undergo a cardiovascular risk assessment before endurance events, including personal and family history, blood pressure, clinical examination, cholesterol and diabetes screening, and an ECG,” says Dr Ramineni.

Further tests, such as an echocardiogram or stress test, should depend on individual risk. Dr Ranga Reddy also stresses medical evaluation for runners with relevant risk factors, particularly a family history of premature heart disease.

YOUR SMARTWATCH KNOWS YOUR PACE. DOES IT KNOW YOUR HEART?

“Heart-rate tracking and rhythm alerts can be useful, but a normal reading cannot exclude coronary blockages, cardiomyopathy or every potentially dangerous rhythm disturbance,” says Dr B. Soma Raju, cardiologist, medical innovator and the former Chairman of CARE Hospitals, who serves as the Consultant Cardiologist and Mentor Director at Sindhu Hospitals .

“Wearable devices can monitor heart rate, sleep, recovery and HRV, but they cannot reliably identify many electrical heart conditions,” says Dr Ramineni.

Dr Ranga Reddy also cautions that fitness trackers cannot reliably detect coronary blockages, structural abnormalities or every dangerous rhythm disorder. A normal reading should not be mistaken for medical clearance.

WHY FITNESS CAN BE MISLEADING

A runner’s pace, body weight and endurance may suggest good health, but they cannot rule out coronary artery disease, inherited heart muscle disorders or electrical abnormalities that can trigger dangerous arrhythmias during intense exercise.

THE BIGGER SAFETY NET

Screening can identify some risks, but no test eliminates every possibility of sudden cardiac arrest. Marathon organisers must also ensure trained responders, rapid CPR, accessible automated external defibrillators (AEDs) and a rehearsed emergency response plan,” adds Dr Soma Raju.

Good stamina is not proof of a healthy heart. A person may run long distances and still have an undiagnosed cardiovascular condition,” says Dr B. Soma Raju.

Warning signs runners must not ignore

Both doctors’ advice reinforces the importance of taking unusual symptoms seriously. Watch for:

l Chest pain, pressure or tightness

l Breathlessness disproportionate to the effort

l Palpitations accompanied by dizziness

l Fainting during exercise

l A sudden, unexplained decline in exercise tolerance

“Stop exercising and seek medical assessment if these symptoms occur. Chest discomfort, collapse or suspected cardiac arrest requires immediate emergency assistance.”

Endurance is not immunity. We train our muscles and build stamina, but must also protect the heart. Running should promote longevity, not become a preventable risk."

— Dr Chandra Shekar Ramineni, orthopaedic surgeon and marathoner

Good stamina is not proof of a healthy heart. A person may run long distances and still have an undiagnosed cardiovascular condition. Screening can identify some risks, but no test eliminates every possibility of sudden cardiac arrest.”

— Dr B. Soma Raju, consultant cardiologist and mentor director, Sindhu Hospitals

Physical fitness does not guarantee cardiac health. Even apparently healthy, well-trained runners may have undiagnosed heart conditions that remain silent until intense physical exertion.”

— Dr BVA Ranga Reddy, Senior Consultant, Cardiologist