Silent Heart Conditions in Teenagers: Understanding Sudden Cardiac Arrest

Expert insight by Dr. Rahul Chaudhary, Head of Cardiology and Consultant Interventional Cardiologist at International Modern Hospital Dubai

Sudden cardiac arrest in teenagers is a rare but devastating event that often shocks families and communities because it can strike young people who appear healthy, active, and symptom-free. Unlike adults, where heart disease is frequently linked to lifestyle factors and blocked arteries, cardiac emergencies in the young are usually driven by hidden electrical or structural problems of the heart that may go undetected for years.

Why can sudden cardiac arrest occur in seemingly healthy teenagers?
In most young people, sudden cardiac arrest is not caused by a heart attack. Instead, it results from an abrupt electrical malfunction that prevents the heart from pumping blood effectively. These electrical disturbances can arise from inherited rhythm disorders or subtle structural abnormalities. Because many of these conditions do not produce early symptoms, a teenager may look fit, perform well in sports, and have no prior diagnosis—until a sudden collapse occurs, sometimes during exercise, emotional stress, or even sleep.

Heart attack versus sudden cardiac arrest in the young
It is important to distinguish between these two terms. A heart attack occurs when blood flow to the heart muscle is blocked, typically due to cholesterol buildup in the arteries—an event that is extremely uncommon in teenagers. Sudden cardiac arrest, by contrast, is an electrical failure of the heart. In young people, cardiac arrest is far more likely than a heart attack, although both remain rare in this age group.

How common are such cases in the UAE?
In the UAE, sudden cardiac events among children and teenagers are thankfully uncommon. However, they do occur, particularly during organized sports or intense physical exertion. Increased awareness, better emergency preparedness, and the growing use of cardiac screening in schools and sports academies have improved detection and response. Even so, these incidents have a profound emotional impact, underscoring the importance of vigilance and readiness.

Underlying conditions that may remain undiagnosed
Several silent conditions are known to increase the risk of sudden cardiac arrest in the young. These include hypertrophic cardiomyopathy, where the heart muscle becomes abnormally thick; inherited electrical disorders such as long QT syndrome and Brugada syndrome; and congenital abnormalities of the coronary arteries. Many of these conditions can exist quietly for years without noticeable warning signs.

Can genetic or congenital heart conditions remain silent?
Yes. This is one of the most challenging aspects of sudden cardiac arrest in teenagers. Some genetic or congenital heart disorders may not cause symptoms during childhood or adolescence. In tragic cases, the first collapse can be the first indication that a problem exists. This reality makes family history and targeted screening critically important.

Warning signs parents should never ignore
Parents and caregivers should be alert to symptoms such as unexplained fainting or collapse—especially during exercise—chest pain on exertion, sudden breathlessness, unexplained seizures, or extreme fatigue that seems disproportionate to activity. A family history of sudden unexplained death, particularly at a young age, should always prompt medical evaluation.

When should cardiac screening be considered?
Screening is advisable for teenagers involved in competitive sports, those who experience concerning symptoms, or those with a family history of heart disease or sudden death. In many cases, a basic assessment—including a clinical examination, electrocardiogram (ECG), and echocardiogram—can help identify high-risk conditions and may be lifesaving.

What saves lives when cardiac arrest occurs?
Immediate action is crucial. Calling the UAE emergency number, 998, without delay ensures rapid professional response. While waiting for emergency services, prompt cardiopulmonary resuscitation (CPR) and early use of an automated external defibrillator (AED) can dramatically improve survival. This is why the presence of AEDs and trained personnel in schools, sports facilities, and public venues is so important. From a public health perspective, integrating basic CPR training into school curricula can empower young people with life-saving skills.

A message for parents and communities
While sudden cardiac arrest in teenagers is rare, it serves as a powerful reminder that serious heart conditions can exist silently. Awareness—not fear—is the key. Listening to symptoms, respecting family history, seeking timely medical advice, and ensuring communities are trained and equipped to respond can make the difference between tragedy and survival.