It was a normal morning at school. A Class VII student in Hyderabad had just reached the school gate when he suddenly collapsed. The boy, reportedly healthy with no known illnesses, was declared dead after being rushed to the hospital. The cause: a silent heart attack. This tragic incident raises an urgent question: Can children suffer heart attacks? How could a heart fail without warning in someone so young? Experts say it’s rare, but not unheard of.
Silent cardiac threats in the young
“Unlike middle-aged or elderly individuals, where heart attacks due to blocked arteries are common, in children and adolescents, sudden cardiac arrest is usually caused by underlying structural or electrical abnormalities in the heart,” said Anjan Siotia, director, cardiology at BM Birla Heart Hospital.
These include congenital heart defects, hypertrophic cardiomyopathy (HCM), arrhythmogenic right ventricular cardiomyopathy, and inherited electrical disorders like Long QT syndrome or Brugada syndrome. Myocarditis, a condition where the heart muscle becomes inflamed, often due to viral infections, is also a growing concern.
Siotia explained that the symptoms in young people that are often subtle or misinterpreted are fatigue, shortness of breath, dizziness, or even stomach pain. “In some cases, a collapse may be the first and only sign. These are often called ‘silent’ cardiac events,” he said.
The invisible signs we often miss
Doctors strongly advocate for annual cardiac screenings for children showing any symptoms or those with a family history of heart disease Shutterstock
Santanu Ray, senior paediatric consultant at Woodlands Multispeciality Hospital, elaborated on the symptoms and causes that caregivers must watch out for. “Children may complain of nausea, breathlessness, chest discomfort or extreme fatigue during exercise. In some, you may notice palpitations, fainting or seizures. These are signs that should never be ignored,” he said.
He highlighted conditions like Long QT syndrome and Brugada syndrome — electrical disorders of the heart that can result in fatal arrhythmias. Another increasingly common cause is viral myocarditis, which can quietly weaken the heart muscle.
Ray strongly advocates for annual cardiac screenings for children showing any symptoms or those with a family history. “Along with an ECG and echocardiogram, a 24-hour Holter monitor should be done if necessary. It’s not about age but risk — and with stress levels in children going up, we are seeing more cases than before,” he said.
Not just an adult disease
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The term ‘heart attack’ may sound like an adult affliction, but Amitabha Chattopadhyay, senior consultant in paediatric cardiology at Narayana Hospital, Howrah, confirms that heart attacks do occur in children, albeit with different causes.
“Kawasaki disease, a rare illness that causes inflammation of the blood vessels, primarily affecting children under 5, especially when it leads to giant aneurysms, is one such condition. There are also anatomical abnormalities like obstruction of the left ventricle or abnormal origin of coronary arteries that mimic heart attack symptoms,” he said.
He added that children with familial hyperlipidemia, a genetic condition leading to very high cholesterol levels, may also develop early coronary artery disease if not diagnosed and treated in time.
Chattopadhyay explained that symptoms can manifest in a variety of ways, depending on the type of heart defect. “We often see two groups — ‘pink babies’ who suffer growth retardation and frequent infections due to shunt lesions like VSD or ASD, and ‘blue babies’ who show signs of low oxygen levels, like bluish lips or nails and clubbing.”
Teachers and parents, he said, must be trained to identify such warning signs early.
The need for awareness and screening
Despite the rarity, doctors agree that cardiac screening for high-risk children could be life-saving. Siotia urges schools and sports academies to implement pre-participation screening protocols. “If a child faints during exercise, has unexplained seizures, or complains of chest discomfort, they must be screened,” he said.
Ray believes parental awareness is equally crucial. “Don’t wait for tragedy. If there’s even a hint of a red flag, be it family history or symptoms, act on it,” he said.
Chattopadhyay added that routine screening is not necessary for all children, but specific cases warrant attention. “Children with a sibling who died young, or a history of unexplained miscarriages in the mother, must be evaluated,” he said.