The sudden death of Kannada superstar Puneeth Rajkumar, who was fit as a fiddle, has once again put the spotlight on the prevalence of heart diseases among the youth, about working out in the gym and silent factors like genetic disposition to certain diseases.
Dr Yusuf Kumble, eminent interventional cardiologist and managing director of Indiana Hospital and Heart Institute, Mangaluru, provides answers to some of our most common questions and dispels myths about heart diseases. Here's a summary of what he says:
What is a sudden death?
The most common cause of a sudden death is mostly related to the heart as against accidents or other causes. From a cardiologist's perspective, a sudden or unexpected death happens within six hours of the onset of symptoms as per European standards and within 12-24 hours according to US standards.
What causes a sudden death? How does it happen?
The most common underlying cause of a sudden death is arrhythmia, or rhythm disturbance of heart. If the heart beats more than 300-400 times per minute, it's called tachycardia or ventricular fibrillation which can result in sudden death if not treated urgently.
These sudden deaths often occur due to a spontaneous rupture of plaque in the coronary artery, which supplies blood to the heart [heart attack]. This could also be due to a old heart attack which causes some scar in the heart which in future leads to ventricular arrhythmia and sudden death; some other causes include structural heart disease, a hidden family history of heart diseases, a severe brain stroke or lung issues etc.
Are there any symptoms that can be recognised by patients who had sudden deaths?
People may have some premonitory symptoms like mild chest discomfort or burning sensation within one or two days before heart attack. In most of the cases patients may not have any symptoms or may have a mild dizziness or some chest pain and discomfort, and within a few minutes patient suddenly become unconscious.
Which people are at the most risk of sudden deaths?
People who are having major conventional risk factors for heart attacks like diabetes, high blood pressure, high cholesterol, smoking and obesity are at higher chances of sudden death. Those with a family history of heart diseases or sudden cardiac death (SCD) are also at risk. Patients who had heart attack and left with reduced ejection fraction (poor pumping of heart) are having high risk of SCD. Also structural heart diseases like HOCM, SEVERE AORTIC STENOSIS, channelopathy, drug abusers and bed ridden patients are having high chances of SCD.
What tests should be done to go for regular exercise programme?
First, getting a baseline ECG is a must. Echocardiogram and treadmill are the main tests used to detect the adequacy of blood supply to cardiac muscles. A few blood tests are also recommended. After seeing these reports, the cardiologist will prescribe what needs to be done and what kind of exercise and lifestyle modification is required. Despite all preliminary investigations, including angiograms being normal, some serious issues can still happen due to hidden diseases. These won't be revealed by conventional tests and need further high-end investigations which are not practically possible unless high suspicions is there.
Are working out in the gym and doing other exercises harmful? How dangerous are they?
The incident that befell Puneeth is a rare case. Only one person in a population of one lakh can have a sudden death. It's not very common. Some studies show that one death can happen in 15,000 people with more than 40 yrs of age. It is not very alarming but since it (Puneeth's sudden death) received widespread publicity, it sends shivers down your spine.
It's prudent to get a proper health evaluation done before signing up for a rigorous gym programme. Any excessive strenuous exercise done in a short span of time is not proper. Conditioning the body before the exercise, especially the warm-up, and cooling down afterwards are a must. An evaluation of family history and physical examination before beginning the exercise regimen are vital.
Any tips for working out that will not put a strain on the heart?
Anything done in moderation is good. Overwhelmingly exhausting yourself is unnecessary. You need to consider the age factor as well. Water intake should be adequate. If you are heavily stressed, do only light exercises and take some rest in-between. Warm up before the exercise and cool down after. Never work out under humid conditions as you will tend to lose electrolytes. Sudden bursts of exercise should be avoided. If you take a long break, you need to first build up a rhythm for exercise.
Can we take Aspirin or other medicines if we anticipate a panic attack?
If a person identifies unusual symptoms or discomfort that he/she never or hardly encountered before or if he/she is not a heart patient, he/she can take Aspirin 325 mg. This pill can be kept handy at home/office or during travel. There is nothing wrong in taking chewable Aspirin tablets without the doctor’s advice even if there's no cardiac cause and no major harm was done. It is safe to take the tablet before seeking medical help.
Another easy option is to call up your doctor friend and take his/her advice. In an advanced case, if symptoms are severe and the chest pain is intolerable and the patient feels the pain radiating towards the left arm, he/she can take Clopidogrel 300mg tablets which would provide an added benefit for high-risk people and those with established cardiovascular disease(s).
What can a bystander do when someone is unconscious or has a severe chest pain?
Everyone must be trained in Basic Life Support (BLS) skills, and the government should make it mandatory for senior students to get trained in Cardiopulmonary Resuscitation (CPR) techniques. Immediate CPR can save the victims of cardiac arrest. These days, social workers have been taking interest in BLS training. It's a good sign.
When a person suddenly collapses, it causes panic. In such a situation, BLS-trained people who are around can help. The next step is to seek the help of the Emergency Medical Service, which is available on the toll-free ambulance number. An EMS manned by trained paramedics should be easily accessible to everyone. The government should ensure that.
Another way to address a cardiac emergency is to instal Automated External Defibrillators at important public places where there is a possibility of large gatherings. Many people are aware of the Cardiopulmonary Resuscitation (CPR), which is given physically, while ventricular fibrillation is handled with a medical device.
My message is to go for regular check-ups for high-risk people. Do not panic although certain deaths are unavoidable. But prevention is always better.

Dr Yusuf Kumble, cardiologist and managing director of Indiana Hospital and Heart Institute, Mangaluru
Let the Truth be known. If you read VB and like VB, please be a VB Supporter and Help us deliver the Truth to one and all.
London (PTI): Bollywood stars Shah Rukh Khan and Kajol huddled under an umbrella on a rainy Thursday in London to unveil their bronze likeness from an iconic ‘Dilwale Dulhania Le Jayenge’ scene.
The sculpture of the duo joins Leicester Square’s ‘Scenes in the Square’ trail depicting memorable shots from some of the world’s most famous films, with ‘DDLJ’ marking a Bollywood first and the 30th anniversary of the 1995 box-office hit. It is in this popular London square that SRK as Raj and Kajol as Simran first cross paths unknowingly.
“DDLJ was made with a pure heart. We wanted to tell a story about love, how it can bridge barriers and how the world would be a better place if it had a lot of love in it, and I think this is why 'DDLJ' has had a lasting impact for over 30 years now," said Khan.
“Personally, 'DDLJ' is part of my identity, and it is humbling to see film, and Kajol and me, receiving so much love since it was released,” he said.
He expressed his gratitude to the Heart of London Business Alliance, behind the cinematic trail at Leicester Square, for celebrating ‘DDLJ’ and “immortalising” its lead stars.
“Seeing ‘DDLJ’ become the first Indian film to be honoured in the iconic Scenes in the Square trail is an emotional moment and has brought back so many memories.
"I feel immense pride knowing the film has been embraced around the world, and I want to share this moment with the entire cast and crew of ‘DDLJ’, my friend and director Aditya Chopra and the Yash Raj Films family. This is a moment I will never forget,” added Khan.
Kajol, joined by her daughter Nysa and son Yug, posed with Khan in front of the statue as she braved the rain in a green saree.
“It’s incredible to see ‘Dilwale Dulhania Le Jayenge’ continue to receive so much love, even 30 years later. Watching the statue being unveiled in London felt like reliving a piece of our history - a story that has truly travelled across generations,” said Kajol.
“Seeing it find its rightful place in Leicester Square, a location of such enormous significance to ‘DDLJ’, makes this moment even more special. For the film to be honoured in this way in the UK – the first Indian film to receive such recognition – is something that will forever stay in the hearts and minds of all the ‘DDLJ’ fans across the world,” she said.
Their statue, captured in a dancing pose from the hit song ‘Mehndi Laga Ke Rakhna’, joins the likes of Harry Potter, Bridget Jones, Mary Poppins, and Batman in what is dubbed as an ever-growing celebration of movie magic in a square packed with multiplex cinema screens.
“When ‘Dilwale Dulhania Le Jayenge’, DDLJ, was released 30 years ago, the film became a defining moment for Indian cinema and changed the face of the industry, capturing the hearts of everyone who saw it all over the globe," said Akshaye Widhani, CEO of Yash Raj Films.
“We’re thrilled to be the first Indian film to be represented in ‘Scenes in the Square’. It also marks 30 years of DDLJ, a film that has spread love and joy globally, and shows the cultural impact it has had in UK.
“We are honoured that our superstars and our film are being recognised on the world stage alongside the Hollywood elite, from Gene Kelly to Laurel & Hardy to Harry Potter. This statue will be a great way to express the international appeal of Indian movies and build bridges amongst communities through cinema,” he said.
Since its release in 1995, ‘DDLJ’ has become the longest-running film in Hindi cinema history.
Ros Morgan, Chief Executive at Heart of London Business Alliance, said: “We’re proud to welcome global megastars Shah Rukh Khan and Kajol to our Scenes in the Square trail.
"Dilwale Dulhania Le Jayenge is a cinematic phenomenon that has shaped generations, and London’s first tribute to Indian cinema honours a story whose magic continues to captivate audiences worldwide.”
It is a particularly special year for the film, with a musical based on the romance playing to packed houses at Manchester’s Opera House earlier this year. Aditya Chopra reprised his role as director of the English language stage production, ‘Come Fall In Love – The DDLJ Musical’, which revolved around the love story of Simran and Roger.
The script was a nod to the original as it followed Simran as a young British Indian woman who finds herself engaged to a family friend in India in an arranged marriage. However, the plot thickens when she falls in love with a British man named Roger.
Bade Bade Deshon Mein, Aisi Chhoti Chhoti Baatein Hoti Rehti Hain, Senorita!
— Shah Rukh Khan (@iamsrk) December 4, 2025
Thrilled to unveil the bronze statue of Raj & Simran at London’s Leicester Square today, celebrating 30 years of Dilwale Dulhania Le Jayenge (DDLJ)!
Incredibly delighted that DDLJ is the first Indian… pic.twitter.com/8wjLToBGYc
