Decoding Heart Attacks While Exercising: Don't Ignore The Warning Signs

Comedian Raju Srivastav has heart attack in the gym: Experts weigh in on why young, fit people have heart attacks

What causes heart attacks during or after workout due to excessive training?

Heart Attack during exercise in gym.

(This story has been republished from FIT's archives in the context of BJP leader Sonali Phogat suffering a heart attack)

Comedian Raju Srivastav was rushed to the hospital on Wednesday, 10 August, after having a heart attack while working out in the gym. He is reportedly on ventilator support.

Another similar incident that unfortunately turned fatal in the recent past was the death of Kannada power star Puneet Rajkumar. The actor, died of a heart attack, at just 46-year-old.

According to media reports, he was exercising in the gym when he had chest pain. A fatal heart attack followed.

Time and again one comes across instances of people, typically young, fit people, having heart attacks and cardiac arrests during or after a workout in the gym, while playing sports, or running a marathon.

But what is the reason something like this happens to a young, active, seemingly fit person?

How can such accidents be prevented? FIT breaks it down.

Wh Is the Risk of Heart Attack or Cardiac Arrest During Exercise?

When it comes to intense exercise like running fast, experts first advise not to overdo it along with the advice of how to do the training.

As Dr Udgeeth Dhir, director and head of Cardiothoracic and Vascular Surgery (CTVS) at Fortis Memorial Research Institute says,

"Anything you do in abundance will only do harm, not benefit. The burden of too much exercise can lead to a heart attack, sudden cardiac death, or a decline in heart function."

Dr Udgeeth Dhir, director and head of Cardiothoracic and Vascular Surgery (CTVS), Fortis Memorial Research Institute

According to the Mayo Clinic, the causes of sudden cardiac death in young people vary.

What's worrying, however, is that in young people, the first symptom of a coronary artery disease often comes in the form of a heart attack.

A heart attack or cardiac arrest during any physical activity usually happens to those people who have already have heart disease or genetic condition, like-

• Any genetic abnormality – such as hypertrophic cardiomyopathy, this condition involves thickening of a portion of the heart muscle, which makes it difficult to pump blood. Due to this, there is no balance between the demand and supply of blood.

• Other rare cases of a life-threatening heart attack on the field or in the gym include the sudden formation of a blood clot in the heart for some reason, affecting blood flow.

A sudden decrease in blood flow in this way causes damage, especially to a healthy heart, which is new to working with low blood flow. If the heart is already weak, then it has passed through that condition.

• There is another situation, when the heart is slowly accumulating cholesterol etc. over the years.

Fat, cholesterol and other things that accumulate in the arteries that supply blood to the heart muscle are called plaques.

When this plaque ruptures in the artery of the heart for some reason, a blood clot is formed there. This blood clot blocks blood flow, which can lead to a heart attack.

Dr Tilak Suvarna, Senior Interventional Cardiologist, Asian Heart Institute, Mumbai, explains that sometimes intense exercise can increase BP and adrenaline hormone, which can lead to minor block i.e. plaque rupture in the artery.

According to Dr Nikesh Jain, Consultant Cardiologist, Jaslok Hospital and Research Center, even though a person may be fit, the amount of plaque also increases with age.

Dr Suvarna adds that people who have a heart attack or cardiac arrest while exercising, may already have a block in the arteries of the heart that they didn't know of.

Therefore, a person should be aware of his medical conditions, along with have information about the factors that increase the risk of blood pressure, cholesterol levels and heart diseases, and should take necessary measures to control them.

Dr Tilak Suvarna says that if you want to do high intensity workout, it is better to consult a doctor and get a checkup done first, although it is not required for daily light exercise.

"Especially if you have a family history of heart attack in young age, or you have high blood pressure, diabetes, smoke, then it is better to get some advanced tests done for intense exercise, so that if there is any problem, then it is better to control it. Necessary medicines can be given."

Dr. Tilak Suvarna, Senior Interventional Cardiologist, Asian Heart Institute, Mumbai

According to Dr Udgeeth Dhir, apart from excessive exercise, protein shakes and steroids for body building can also weaken the heart muscles.

On the risk of heart diseases from bodybuilding supplements, Dr Suvarna says that there is no strong evidence to support this, but it is better to avoid them, especially in excess, as they affect the body and can cause harm. The same goes of excessive exercise.

Overall, he talks about balance in everything.

The Warning Signs That Says You Should Stop Exercising

Dr Suvarna says that if while exercising, you experience these symptoms, chest pain, then you should stop immediately, and a checkup done as soon as possible.

• Breathlessness

• More fatigue than usual

• Dizziness

• Light headedness

If you are already experiencing one or more of these symptoms ona regular basis, refrain from exercising altogether till you get a check up done and get the go ahead for your doctor.

"If the pulse rate is continuously going above 90-100 without any reason, feeling unreasonably tired or feeling like there is some strain in the neck or there is a heaviness in the chest or there are symptoms of excessive gas formation, then these are warning signs."

Dr. Udgeeth Dhir, Director and Head, Cardiothoracic and Vascular Surgery (CTVS), Fortis Memorial Research Institute

Dr Suvarna says, “Though screening for heart diseases are recommended after 40 years, in India one should start getting them done from the age of 30, especially if there is a family history of cholesterol, BP, or you have risk factors like diabetes, smoking, overweight, stress, sedentary lifestyle."

Dr Santosh Dora, Senior Cardiologist of the Asian Heart Institute, says that caution and alertness should not be ignored in favour of the enthusiasm for fitness and stamina.

What Precautions Should Be Taken During Exercise?

Regular exercise is very important for your health and there is no need to count the benefits of exercise.

All you have to remember is that every person's body is different and reacts differently to different exercises.

While exercising, it is important that we know the limits of our body, stay hydrated and follow a certain type of high intensity exercise routines only under professional guidance.

• If you have not been very active till now, then do not suddenly practice hard exercises etc. Set your fitness goal, but try to achieve it gradually.

• Before starting any high-intensity exercise, get the necessary cardiac checkup or screening done by a doctor. This is especially recommended for people with coronary artery disease, high cholesterol, diabetes, or a family history of heart disease.

For high-intensity exercise, the doctor may conduct ECG, routine blood tests, 2D-echocardiograms and sometimes stress tests before giving you the green light.

• Exercisers should be aware of the symptoms and signs that can prove to be dangerous.

• A gradual warm-up and cool-down period is crucial in any workout.

• Do not do anything that your body cannot tolerate. Prepare the body for an exercise program comfortably.

According to doctors, the use of a defibrillator along with CPR and a massage can be helpful in saving lives in such cases. This is why it becomes important to provide basic CPR training in school, office, college and gym.

At the same time, experts also insist on the appointment of trained people for emergencies in places like gyms.