Is all that running actually good for you?
Fitness is not a guarantee of cardiac health. Even apparently healthy runners can harbour undiagnosed cardiovascular conditions that may become evident during intense exertion, experts warn.
Recent deaths at running events in India have spotlighted silent cardiac risks, screening gaps and emergency preparedness. The 2024 Tata Mumbai Marathon saw two participants, aged 40 and 74, die. Twenty-five-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.
Medical experts emphasize that strong muscles and good stamina do not equate to cardiac immunity. Silent conditions such as coronary artery disease, hypertrophic cardiomyopathy and inherited heart disorders can go undetected, even in fit individuals. "As both a runner and a doctor, I would never want to confuse endurance with immunity," said 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 at 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."
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.
"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," said Dr Ramineni. Further tests, such as an echocardiogram or stress test, should depend on individual risk.
Dr B. Soma Raju, cardiologist and former Chairman of CARE Hospitals, warns: "Heart-rate tracking and rhythm alerts can be useful, but a normal reading cannot exclude coronary blockages, cardiomyopathy or every potentially dangerous rhythm disturbance. Wearable devices can monitor heart rate, sleep, recovery and HRV, but they cannot reliably identify many electrical heart conditions."
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.
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.
"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.
Warning signs runners must not ignore include chest pain, pressure or tightness; breathlessness disproportionate to the effort; palpitations accompanied by dizziness; fainting during exercise; and 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," the doctors advise.
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
