While regular physical activity is widely recognized for its benefits to cardiovascular health, incidents of heart attacks during workouts do happen. These events are almost always linked to underlying, often undiagnosed, heart conditions that make individuals vulnerable to the physiological stresses of exercise. Understanding the factors that contribute to these occurrences can help individuals assess their risk and take appropriate preventative measures.
Underlying Heart Conditions
Heart attacks during exercise are primarily due to pre-existing heart conditions that may not have been previously identified. Coronary artery disease (CAD) is a common underlying cause, where arteries supplying blood to the heart become narrowed or blocked by plaque buildup. During physical exertion, the heart demands more oxygen-rich blood; if arteries are constricted, a clot can form, leading to a heart attack.
Hypertrophic cardiomyopathy (HCM), characterized by a thickened heart muscle, can impede blood flow and increase vulnerability during exercise. Undiagnosed structural heart abnormalities or electrical issues, such as arrhythmias, can also disrupt the heart’s pumping ability under stress. These conditions mean the heart is already compromised, and exercise acts as a trigger rather than the sole cause.
Exercise-Related Triggers
Exercise can precipitate a heart attack in someone with an underlying heart condition. Sudden, intense exertion, especially without a proper warm-up, places immediate and excessive strain on the heart. This rapid increase in heart rate and blood pressure can stress an already compromised cardiovascular system.
Dehydration and electrolyte imbalances can disrupt normal heart rhythms and make the blood thicker, increasing the heart’s workload. Stimulants can also elevate heart rate and blood pressure, further straining a vulnerable heart. Exercising in extreme temperatures also contributes, as cold weather can constrict blood vessels, and high heat can lead to excessive dehydration.
Identifying Risk and Warning Signs
Risk factors for heart disease increase susceptibility to a heart attack during exercise. These include age, a family history of heart disease, smoking, high blood pressure, high cholesterol, and diabetes. A sedentary lifestyle, followed by sudden intense exercise, also elevates risk.
Warning signs before or during exercise include chest pain or discomfort, shortness of breath, or pain radiating to the arm, back, neck, or jaw. Other signs are lightheadedness, dizziness, nausea, or unusual fatigue. Symptoms can be subtle, particularly in women, so be aware of any unusual physical changes.
Prevention and Emergency Preparedness
To mitigate risk, individuals should consider getting a medical check-up before starting a new exercise program, especially if risk factors are present. This allows for assessment of heart function under stress and detection of any underlying conditions. Gradually increasing exercise intensity and performing a proper warm-up avoid sudden strain on the heart.
Listening to one’s body and stopping exercise immediately if unusual symptoms occur is paramount. Maintaining proper hydration and avoiding stimulants can also reduce risk. Knowing basic CPR and the location of automated external defibrillators (AEDs) in a gym can be life-saving. If heart attack symptoms appear, stop the activity, seek immediate help, and call emergency services without delay.