Hyderabad techie dies after completing marathon: Why the heart can suddenly give up

The finish line should have been the happiest moment of his life. He had completed 42.2 kilometres, collected his finisher’s medal and achieved what thousands of recreational runners aspire to. But within minutes, the celebration turned into tragedy.

On November 1, 2026, Kommineni Gopi, a 36-year-old software engineer working with IBM and a resident of Manikonda in Hyderabad, collapsed shortly after completing the Hyderabad Hi-Tech Full Marathon at Gachibowli Stadium. According to media reports, he had collected his medal and was walking towards the breakfast area when he suddenly collapsed. Event organisers rushed to his aid, performed cardiopulmonary resuscitation (CPR) and shifted him to a nearby hospital. He was declared dead, possibly because of a heart attack, which is caused by blockage in the arteries, or a sudden cardiac arrest, when the heart stops as electrical impulses shut down. It raises an uncomfortable but important question: How can someone who is fit enough to complete a full marathon die suddenly moments after crossing the finish line?

“Physical fitness and cardiovascular health are not necessarily the same thing. In athletes and recreational exercisers above 35 years of age, one of the leading causes of exercise-related sudden cardiac death is underlying coronary artery disease (CAD) that has never been detected. This is largely because fit and active people appear healthy, believe they are doing all things right and may not be rigorous about getting themselves tested,” says Dr Balbir Singh, chairman, Cardiac Sciences, Max Healthcare. Excerpts:

Coronary artery disease: Why it affects regular athletes

The European Society of Cardiology reports that more than 80% of sudden cardiac deaths in athletes above 35 are attributable to coronary artery disease or CAD. It develops gradually when cholesterol-rich plaques accumulate within the coronary arteries, which supply blood and oxygen to the heart muscle. The process may continue silently for years, without producing obvious symptoms. A person may walk regularly, cycle, swim or even run long distances without realising that significant coronary disease is developing because his heart can absorb the stress and appear well-oiled because of their fitness levels. In such individuals, the first manifestation of coronary artery disease may be a heart attack or sudden cardiac arrest rather than the familiar warning of chest pain.

How can a seemingly healthy artery suddenly become dangerous?

One of the important mechanisms is plaque rupture. A cholesterol-rich plaque may remain relatively stable for years without causing a major obstruction to blood flow. During intense physical exertion, however, heart rate, blood pressure and the heart’s demand for oxygen rise considerably. In a susceptible individual, a vulnerable plaque can rupture. The body’s clotting mechanism responds by forming a blood clot at the site of rupture. If the clot suddenly blocks the coronary artery, blood supply to a portion of the heart muscle is interrupted.

This can produce an acute heart attack. It can also trigger a dangerous electrical disturbance in the heart, resulting in ventricular fibrillation. In simpler words, the heart’s electrical activity becomes chaotic and the heart can no longer pump blood effectively. The person collapses within seconds when the irregular heartbeats stop. This is sudden cardiac arrest, a medical emergency requiring immediate CPR and defibrillation.

Why can vigorous exercise act as a trigger?

Exercise is undoubtedly one of the best investments in long-term health. Regular physical activity improves cardiovascular fitness, helps control blood pressure, reduces diabetes risk and protects against several chronic diseases. However, intense exertion temporarily places additional demands on the cardiovascular system. In someone with an underlying heart condition, this can occasionally trigger an acute event.

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What’s happening inside the heart?

1. A surge of adrenaline: During vigorous running, the body releases adrenaline and other stress hormones. These increase heart rate, blood pressure and the force of cardiac contraction. In a healthy heart, this is an appropriate physiological response. But in a heart affected by coronary disease, scarring or irregular heartbeats, the increased sympathetic stimulation can provoke dangerous rhythm disturbances.

2. Increased oxygen demand: During a marathon or high-intensity workout, the muscles require substantially more oxygen. The heart must pump faster and harder to meet this demand. If the coronary arteries are narrowed or blood supply is compromised, the heart muscle may not receive sufficient oxygen. This imbalance between oxygen supply and demand can potentially trigger a serious arrhythmia.

3. The period immediately after exercise: The risk does not necessarily disappear the moment a runner crosses the finish line. During recovery, heart rate, blood pressure and autonomic nervous system activity undergo rapid changes. Research indicates that the risk of an acute cardiac event can remain temporarily elevated during vigorous exercise and for a period afterwards. The American College of Cardiology’s 2026 scientific statement notes that the relative risk of cardiac events is increased during exercise and for up to an hour afterwards, although the absolute risk remains small.

This is why a proper cool-down, medical observation when indicated and prompt attention to symptoms after an endurance event are important.