NEW DELHI: Heart disease is increasingly showing up in Indians well before old age, catching even the physically fit off guard. A recent National Statistical Office (NSO) survey reveals a threefold spike in cardiovascular ailments, rising from 1,333 per lakh population in 2017-18 to 3,891 in 2025.Cardiovascular conditions accounted for 2.1% of reported ailments among 15 to 29-year-olds and 15.3% among those aged 30 to 44 years. They were also behind 3.4% of hospitalisations among those in the 15 to 29 bracket and 7.3% among those aged 30 to 44. From 30 onwards, NSO identifies hypertension and diabetes as major contributors to cardiovascular and metabolic ailments. The ICMR-backed study found 53.4% of cardiovascular deaths in 2016 occurred before 70 years of age.Delhi recorded 22,385 institutional deaths from heart attack and related heart diseases in 2023, compared with 8,576 in 2005; 21.9% of institutional heart disease deaths were among those aged 15 to 44. Studies point to a rise in obesity, hypertension and elevated blood glucose. In 2023, 1,595 of 10,080 people screened in Delhi were suspected to have hypertension.Cases recently handled by Delhi doctors underline how the disease can present itself unexpectedly, especially in younger people who appear fit.CASE 1: Badminton Enthusiast, 38He played badminton for an hour every day and had no diabetes or hypertension, never smoked, and didn’t have a family history of heart disease. Suddenly, he began tiring after 30 minutes on court. A coronary angiography showed disease in all three major coronary arteries, with one completely blocked, prompting a triple bypass.“The patient had no conventional risk factors. The only thing he noticed was his stamina on the court had quietly dropped,” says Dr Varun Bansal, senior consultant, cardiothoracic and vascular surgery, Indraprastha Apollo Hospitals.CASE 2: 18-Year-Old GirlWhen this otherwise healthy girl complained of severe palpitation, breathlessness and near-blackouts, doctors found her heart’s pumping ability had fallen to 30%, while repeated episodes of dangerous ventricular tachycardia required emergency shocks. Enlarged, painless lymph nodes were spotted and a biopsy confirmed cardiac sarcoidosis, an inflammatory disease affecting the heart.After high-dose steroids and medication, the arrhythmias stopped and her heart function improved to 45%-50%.Dr KK Talwar, chairman, cardiology, PSRI Hospital, says it highlights the need to look beyond an “idiopathic” diagnosis in young patients with unexplained heart failure and dangerous arrhythmias.Case 3: Heart attack at 37A man just diagnosed with severely uncontrolled diabetes at 37 suffered an NSTEMI – a type of heart attack in which a coronary artery is severely blocked or narrowed, restricting blood flow to the heart muscle.He was found to have severe triple-vessel coronary artery disease and a reduced heart-pumping function. An urgent bypass surgery on three diseased coronary vessels was performed. “Serious coronary artery disease can occur even at a young age, particularly when risk factors like uncontrolled diabetes and a sedentary lifestyle are present,” says Dr Vaibhav Mishra, senior director, Max Super Speciality Hospital, Patparganj.CASE 4: 4 Blocked ArteriesThis man visited RML Hospital with four months of exertional chest pain. Tests showed myocardial-infarction-related changes and tight blockages in all major coronary arteries. With no diabetes, hypertension or history of tobacco use, doctors probed genetic and metabolic factors and found his father had undergone bypass surgery. The man had to undergo a four-graft coronary artery bypass graft.“Coronary artery diseases occur at an early age in today’s generation, yet the presence of a genetic cause holds precedence,” says Dr Narender Singh Jhajhria, cardio surgeon, RML.