In their 20s, their hearts seemed normal: What was lurking beneath?

Two women in their 20s appeared to have perfectly normal hearts - but inside them, clandestine conditions were causing turmoil. Sayanee Banerjee, 29, lived with unexplained blackouts, racing heartbeats and an undetected tumor. Rima, born with a congenital hole in her heart, had been breathless for 13 years before doctors uncovered a rare condition called cor triatriatum.

Their uncommon conditions prompt an important question: when a young heart behaves erratically, but the cause remains hidden, what happens next? Both women, busy with studies, family, and routine, experienced a range of symptoms. Sayanee, an MTech graduate in nanotechnology and UPSC exam preparer, experienced blackouts that first occurred while out with her parents and later in a mall.

Her heart rate regularly exceeded 110 beats per minute, even at rest. She underwent multiple consultations with cardiologists who initially attributed her symptoms to stress and anxiety. It wasn't until advanced imaging revealed a hidden tumour that a clearer picture emerged. The tumour, a cardiac lipoma, was located near the heart's electrical system, causing irregular, dangerously fast heartbeats.

Rima's story unfolded differently. At eight, she underwent surgery to close a hole in her heart, but she continued to experience breathlessness for a decade. When she was 21, a referral to Safdarjung Hospital led to the discovery of a rare congenital condition called cor triatriatum. This condition involved an abnormal membrane dividing the left atrium into two chambers, obstructing blood flow from the lungs.

Both women's cases underscore the reality that heart disease in the young can present in subtle ways, making diagnoses challenging, even when initial tests appear normal. Experts explain that the location of Sayanee's tumour made it difficult to detect on routine tests, while Rima's symptoms persisted beyond the expected recovery from her initial surgery.

The takeaway? A normal-looking heart on an initial test does not always tell the whole story, highlighting the importance of further investigation when symptoms arise in young individuals.