Among communicable diseases, tuberculosis (TB) is the major cluster causing mortality in young patients. WHO reported a global estimation of 10 million people fell ill with tuberculosis (1.5 million fatalities in 2020), and India alone contributed about26%.The incidence of Extra pulmonary Tuberculosis (ETB) is about 15% of all TB cases in India. Central nervous system (CNS) tuberculosis accounted for approximately 1% of total tuberculosis. TB is a rapidly progressive and fatal disease if left untreated. The progression of the disease and the occurrence of complications vary from patient to patient. Here the authors present a case of a young adult who presented with acute onset of fever and headache and she expired within a span of 31 days after the symptoms began. The novelty in the case is that an undiagnosed rare cardiac complication of extra pulmonary tuberculosis was diagnosed at autopsy. The investigations prior to her death didn’t indicate TB, but the treating physician had suspected ETB. The autopsy examination and histopathological examination supported the physician’s diagnosis. The authors had deliberated the pathogenesis of the cardiac complication of extra pulmonary tuberculosis contributing to the death of the deceased.