When Exercise Becomes a Risk to the Heart
Heart in trouble with exercise overload
Losing weight is commonly the agenda in everyone’s new year’s resolutions list. One of the most effective and practical ways of gaining one’s ideal weight and fit is adopting a healthier and more active lifestyle. However, there is a common misconception that physical fitness equates to heart health. The adrenaline-fueled pursuits of athletes often inspire many of us to push our limits. However, behind the façade of peak physical performance lies a hidden risk – the potential for sudden cardiac arrest (SCA) or sudden cardiac death (SCD) to happen.
The recent shocking cardiac arrest experienced by the 29-year-old Premier League player, Tom Lockyer1, adds to the perplexity of exercise routines for professional athletes, who may also be at risk of succumbing to heart failure. These instances challenge the traditional belief that athletic excellence inherently ensures heart health, prompting a deeper probe into the relationship between intense training regimes and cardiovascular well-being.
Understanding arrhythmias and sudden cardiac death (SCD)
Arrhythmias, characterised by abnormal heart rhythms, can present as the heart beating too fast, too slow, or irregularly. Dr Tee Chee Hian, Sunway Medical Centre Velocity’s (SMCV) Consultant Cardiologist and Internal Medicine Physician, explains, “Arrhythmias can disrupt the heart’s coordinated contraction and relaxation, potentially leading to serious complications, including sudden cardiac death (SCD).”
Arrhythmias can trigger SCD by compromising the heart’s pumping function, leading to a rapid decline in blood flow, causing hemodynamic instability, reducing oxygen supply to organs, and, in severe cases, inducing ventricular fibrillation, which can result in unconsciousness and, if untreated, sudden cardiac death.
Know if you are prone to arrythmias
Experts discuss several risk factors, symptoms, and age groups that are prone to arrhythmias. Recognising the risk factors associated with arrhythmias is paramount, encompassing an understanding of their symptoms and awareness of age groups more susceptible to these conditions:
1 . Signs – A common yet distinctive sensation often reported is the feeling of the heart “skipping a beat.” Dr Tee further elaborates, stating, “Arrhythmias can manifest through palpitations, dizziness, fainting, chest discomfort, shortness of breath, and fatigue.”
2 . Age – While arrhythmias can impact individuals of any age, the risk factors vary across different age groups, influenced by factors such as aging, heart disease, genetic predisposition, and lifestyle choices.
3 . Risk factors – Key contributors to the risk of arrhythmias and sudden cardiac death include heart disease, a history of heart attacks, specific medications, genetic factors, and lifestyle choices such as smoking and excessive alcohol consumption.
Therefore, Dr Tee underscores the significance of regular check-ups and the prompt treatment of underlying heart conditions to mitigate potential complications. Most notably, arrhythmias can have an inherited component, and in some cases of sudden cardiac arrest (SCA) have been linked to excessive exercise, particularly in athletes.
While endorsing resolutions for a more active lifestyle, Dr Tee advises caution, stating, “Excessive or intense exercise, especially for those unaccustomed or with pre-existing heart conditions, can increase the risk of arrhythmias and, in severe cases, SCA.”
He encourages individuals to be mindful of their health, consult healthcare professionals, and pay attention to the various symptoms. Warning signs that could indicate excessive exercise include physical and performance-related indicators like persistent fatigue, frequent illnesses, changes in sleep patterns and performance plateau or decline, as well as psychological and physiological signs such as mood disturbances, menstrual irregularities, and changes in heart rate.
Additionally, recognising individual limits is crucial. For instance, individuals dealing with weight issues are advised to start their fitness journey gradually, choose low-impact activities, and stay vigilant for symptoms like chest pain, shortness of breath, or palpitations. This precautionary approach ensures one doesn’t overexert themselves unknowingly.
Lastly, Dr Tee underscores the significance of well-rounded exercise routines, adequate rest, proper nutrition, and sufficient recovery for fostering a healthy approach to physical activity.
Diagnostics, monitoring and intervention for optimum heart health
To fortify heart health, a range of diagnostic methods is available for identifying and understanding arrhythmias. Essential among these is the Electrocardiogram (ECG or EKG), a widely used tool recording the heart’s electrical activity, adept at detecting abnormal rhythms. Portable variation like Holter monitors is also available, offering extended monitoring that enables the ability to capture intermittent arrhythmias that are not evident in standard ECGs.
Dr Tee stresses the significance of knowing and monitoring your normal heart rate before and during exercise even when you don’t witness symptoms, as this aids in the early identification of potential issues. Therefore, the importance of consulting healthcare professionals is crucial as they can tailor interventions based on individualised diagnostic approaches, ensuring an accurate diagnosis for optimal heart health.
However, in the event of sudden cardiac arrest (SCA), besides calling for emergency assistance, immediate first-aid measures such as cardiopulmonary resuscitation (CPR) can make or break a situation. Dr Tee emphasises the importance of equipping oneself with basic CPR skills, highlighting its potential to significantly improve survival chances while waiting for professional help.
By integrating these intervention strategies, individuals contribute to a well-informed community committed to cardiovascular well-being.
Sources:
1 . https://www.freemalaysiatoday.com/category/sports/2023/12/21/lutons-lockyer-discharged-from-hospital-after-on-pitch-cardiac-arrest/
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