Currently, there is a worrisome trend of heart attacks among gym goers in the country and the recent deaths of celebrities Siddhaanth Surryavanshi and Raju Shrivastav, who succumbed to heart attacks while working out, have left people wondering why youngsters are getting heart attacks after hitting the gym. Youngsters under 50 are getting heart attacks after hitting the gym and health experts insist upon some important instructions that one should follow before hitting the gym.
It is a proven fact that exercising daily can boost one’s heart health but now, the cases of heart attacks while exercising is rising at a rapid rate among men above 45 years where it is believed that over-exercising can raise the risk of heart problems. In an interview with HT Lifestyle, Dr Bipeenchandra Bhamre, Consultant Cardiac Surgeon at Sir HN Reliance Foundation Hospital and Research Centre in Mumbai, shared, “First we must understand that during exercise we should not ignore symptom of heart pain like heaviness, left shoulder pain, throat pain, back pain. If you are getting such symptoms, you should stop exercise.”
He highlighted, “People with pre-existing diabetes, high blood pressure, smoking history, family history of heart disease should be more careful not to overexert in gym. When one is working out, it is essential for the person to avoid too much or exercising too fast. Mindless exercising can put a strain on the heart. So, going for too many reps, having excess weight, running without any breaks, and exercising for a longer time will lead to a heart attack while doing any activity. Moreover, this happens when one has not been active since childhood and suddenly takes up any activity without knowing his fitness level.”
He explained, “Not many people are active physically and then they suddenly plan to become fit and adopt a healthy lifestyle but it is necessary to know the health status before hitting the gym. Stop exercising immediately if you feel heaviness in chest or back, feel nauseous, dizzy or feel like you will collapse as this can indicate an underlying problem. Sudden cardiac arrest while exercising happens due to existing blockages, diagnosed or undiagnosed, in one’s heart. Also, too much pressure on the heart leads to plaque rupture or triggers electrical disturbances in the heart and that is how one can get a sudden cardiac arrest.”
Talking about some essential tips that gymgoers should follow, Dr Bipeenchandra Bhamre advised, “If one is planning to undertake any exercise routine the n makes sure you speak to your doctor before doing so. Don’t forget to get your cardiac screening done to know about your heart health. Opt for activities such as brisk walking, jogging, cycling, swimming, and yoga for 150 minutes at least 5 days a week. It is better to exercise for 45 minutes every day instead of doing it for 2-3 hours at a stretch. Do not exercise if you have body pain, or feel breathless or weak. Start exercising slowly and gradually. If you feel unwell then skip exercising on that particular day instead of pushing yourself. Exercise as per your capabilities and avoid pushing yourself just because others are doing it.”
Given that ‘fitness’ has emerged as the new-age mantra of young and old alike in India today, it is common knowledge that regular exercise helps the heart and also lowers long term risk of cardiovascular problems but the same doesn’t hold good for strenuous exercise, which, in fact, increases the immediate risk for a heart attack and a sudden cardiac arrest, especially in people who are already predisposed to heart disease, either due to genetic factors or a poor lifestyle. Dr Adil Sadiq, Head, Cardiothoracic and Vascular Surgery at Sakra World Hospital in Bangalore, revealed, “Unaccustomed strenuous activity, can cause a sudden mismatch in the blood supply-demand equation of the heart, precipitating a heart attack. In addition it may cause the rupture of a pre-existing plaque in the arteries of the heart, or trigger an abnormal heart rhythm, both of which can cause cardiovascular collapse. In rare instances, people with a genetic abnormality of the heart muscle like obstructive cardiomyopathy can also be subject to the same problems on strenuous exercise.”
He insisted that it is imperative to understand that going to the gym is not the problem but the lack of a structured, progressive and monitored exercise regime is the culprit. He suggested, “If a person has a predisposing condition to heart disease like hypertension, diabetes mellitus, smoking or a family history of heart disease, it is important to be evaluated along cardiovascular lines, prior to starting with strenuous exercise. Just as the heart is in a dynamic state, gym-goers need to keep a watch for any unusual symptoms during exercise, like light-headedness, shortness of breath, chest tightness or pain and get themselves evaluated if they experience the same. Choosing the right gym is another point of consideration. Data has shown that a gym that is equipped with an AED (automated external defibrillator) device or has personnel trained in CPR (cardio-pulmonary resuscitation), is always better equipped to deal with a heart attack at the workout place, than one which lacks these facilities. All-in-all, the gym is great place to exercise, train and boost your energy but getting yourself evaluated prior to any unaccustomed activity, or any strenuous activity along with knowledge of the ominous symptoms during exercise is key to keeping the gym a safe place and preventing a large number of possible cardiovascular events.”
Bringing his expertise to the same, Dr Vikram Kolhari, Consultant Cardiologist at Apollo Hospitals in Bangalore’s Seshadripuram, said, “There is substantial evidence that moderate intensity exercise is associated with reduced cardiac events, however vigorous exercise can sometimes trigger a heart attack and sudden death in people with pre-existing heart conditions and those with sedentary lifestyle. A study in US found that about 16% of indoor sudden cardiac arrests occurred in exercise facilities. Intense exercise can increase heart rate, blood pressure and adrenaline hormone levels, which can lead to a plaque rupture, precipitating a heart attack.”
He recommended, “We should know our risk factors for cardiovascular diseases and have them addressed with appropriate medical advice. If someone has a family history of heart attack or other risk factors like hypertension, diabetes mellitus, smoking and high cholesterol, it is better to get certain tests in advance before starting exercise and get appropriate treatment, if required. Preventive check-ups including tests like ECG, ECHO, TMT and CT or CAT and coronary angiogram are useful to recognise asymptomatic blockages in the coronary arteries. It is advisable to do moderate intensity exercises like brisk walking, jogging, swimming or cycling for at least 5 days a week for a healthy life. Start slow and gradually increase the intensity and know your limits.”
Dr CH Praveen, Consultant, Cardiothoracic and Vascular Surgery, Omni Hospital in Andhra Pradesh’s Kurnool, echoed that recently, we have witnessed an increasing upward trend for cardiac arrests or cardiac issues over the years, due to suddenly resuming workouts and poor gym practices. According to him, the increasing risk of heart diseases in youngsters is multi-factorial –
1. Pushing one’s limits beyond his or her capacity is a trend in gym today, which has led to increased demand or strain of heart. One must compare heart with a motor and pushing the motor beyond its capacity heats it up. Pushing your heart for a longer duration results in its arrest.
2. Increased dehydration during work out in gym doesn’t only mean loss of fluids like water but also essential electrolytes like potassium and sodium. Both are essential for the normal rhythm of heart.
3. Routine annual health check up to screen asymptomatic individuals with cardiac diseases in early stage, is not followed in our country. We must all remember that “Health is Wealth”.
4. Increase in unhealthy and sedentary lifestyle among younger generations with smoking (active and passive), consumption of alcohol, diabetes, hypertension, obesity and family history.
Sharing his opinion, he adviced:
I. ‘Know when to stop’ – Gymming is good to keep your body healthy, but do not push yourself beyond a limit. Do not go beyond the capacity of your heart.
II. ‘Hydrate yourself with water and minerals’ – To prevent life threatening arrhythmias leading to sudden cardiac arrest, one should hydrate themselves intermittently. A very expensive oxygen enriched water is not needed. Plain ORS will also do. Indirect evidence of impending cardiac arrhythmia is a muscle spasm which is most commonly result of hypokalemia (less potassium).
III. “Prevention is better than cure” – Keep yourself away from avoidable risk factors like tobacco (in any form), alcohol (in any form), junk or fatty food and steer clear from obesity. Continued medical check-ups is a must for unavoidable risk factors like diabetes, hypertension or any other family history. A routine annual health checkup for all individuals over 30 years of age, instead of 40, should be mandated with present scenario of cultural shift.