FACT-CHECK: Is Hypertrophic Cardiomyopathy the leading cause of sudden deaths in young gym-goers?
While a viral Instagram reel links sudden gym deaths to a genetic heart condition, find out what experts say and why more research is needed to understand the true cause
Author
CLAIM: Hypertrophic Cardiomyopathy (HCM) is the leading cause of sudden deaths among young gym-goers during exercise
FACT: Further studies are required to determine the true incidence of HCM-related sudden cardiac deaths and its risk factors, with no comprehensive data on HCM prevalence in India
An Instagram reel posted by @dr.arshad01 attributes the sudden death of the young gym-goers to a genetic condition called Hypertrophic Cardiomyopathy (HCM). In the video, the presenter Dr Arshad explains that the condition, characterized by an unusually thick heart wall, can lead to fatal consequences during intense physical exertion, when blood flow demand increases sharply. The reel, which includes a TV news report showing a person collapsing and dying at a gym, advocates preventive measures such as echocardiography to identify and manage HCM risk among young gym enthusiasts.
“Recently, there have been cases of young people dying suddenly in gyms, and everyone thinks it's due to heart attacks. But that's not entirely true,” the presenter says and then goes on to explain the reason behind such sudden deaths.
“This condition is called Hypertrophic Cardiomyopathy, a genetic problem where one wall of the heart becomes abnormally thick. Typically, people with this condition don't experience any issues, but when they engage in heavy exercise at the gym, their body demands more blood. At this point, the thick heart wall can obstruct the heart's pumping mechanism, causing the heart to fail and resulting in instant death,” he explains.
His treatment: “So, how can you prevent this? You can undergo an echocardiography test, which can detect hypertrophic cardiomyopathy, allowing for timely treatment and precautions. If you're a gym enthusiast, consider getting this test done,” he suggests.
The video has garnered 4.1 million views, 141, 000 likes and more than 166,000 shares on Instagram.
What is the fact?
Although HCM is traditionally considered one of the leading causes of heart attack, medical experts and studies don’t see it as the only condition responsible for cardiac events among young gym-goers.
“Sudden cardiac death is typically caused by ventricular fibrillation, a condition where the heart loses its rhythm,” Dr Shiv Kumar Choudhary, a Cardiovascular and Thoracic Surgeon at Fortis Hospital in New Delhi, told The Week. “Two primary reasons for ventricular fibrillation are heart attacks and Idiopathic Hypertrophic Subaortic Stenosis (IHSS), which is closely related to HCM. In addition, factors like excessive stress, which can lead to coronary artery issues and blockages, must be considered, particularly in younger individuals.”
Dr. Choudhary highlighted that the unaccustomed strenuous exercise can strain the heart, causing a mismatch in blood supply, plaque rupture, or abnormal rhythms, leading to heart attacks or collapse. Genetic heart conditions like obstructive cardiomyopathy can also trigger these issues, but it is rare, he added.
"We lack comprehensive data from India to confirm how common HCM cases are in India. However, aggressive exercise can exacerbate this condition in predisposed individuals,” Dr. Choudhary said. “My advice is for those engaged in intense physical activity to undergo a screening echocardiogram, although it may not be mandatory for everyone.”
Rising stress levels among young people could be contributing to the increasing occurrence of heart attacks, the heart specialist pointed out.
“Modern medicine often overlooks stress as a significant factor,” Dr Choudhary said. “Chronic stress can cause issues in coronary arteries, potentially leading to blockages and, subsequently, heart attacks.”
A 2022 study estimated that 0.2-0.5% of the global population has HCM, though most cases (80-90%) go undiagnosed. Applying this to India’s population of 1.43 billion, the study suggests 2.86-7.15 million Indians may have HCM.
A US-based study has found that about 16% of indoor sudden cardiac arrests occurred at exercise facilities. Another study attributed the events to rise in heart rate, blood pressure and adrenaline hormone levels due to intense exercise, which can lead to a plaque rupture, precipitating a heart attack.
Yet another study that investigated the phenomenon among athletes found that Sudden Cardiac Death (SCD), while rare, is caused by different factors depending on age. In older athletes, SCD is primarily linked to coronary artery disease (CAD) and related complications. In younger athletes, it is often due to congenital or genetic conditions like hypertrophic cardiomyopathy (HCM), coronary artery anomalies, systemic hypertension or arrhythmogenic disorders.
A study examining HCM-related SCD in a large, unselected population found that events in individuals aged 10 to 45 are much lower than previously reported, with most cases occurring in undiagnosed individuals, and SCDs are rarely linked to exercise.
Further studies are needed to understand the incidence of HCM-related SCD and its risk factors. There is no comprehensive data to confirm the prevalence of HCM cases in India, making it difficult to support this claim.
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