July 3, 2017

Can We Get Too Much Exercise?

This is especially important when there has been any history of heart disease, undiagnosed chest pain, or shortness of breath.

Peter N. Landless & Zeno L. Charles-Marcel

Q: I am 35 years old. Encouraged by the regular emphasis on exercise in the health columns, I have developed a daily exercise routine. I walk 10,000 steps daily and feel good. I recently read that athletes can die suddenly while exercising. Am I at risk?

A: We advise people to consult with their health-care provider before embarking on an exercise program. This is especially important when there has been any history of heart disease, undiagnosed chest pain, or shortness of breath. A family history of sudden cardiac death raises further suspicion.

It seems to make sense that the greatest worry would be for older people. Most sudden cardiac arrests (SCA) during physical exertion, however, occur in people under the age of 40, and most of those under the age of 20. Most victims are male. If not treated immediately, SCA becomes sudden cardiac death (SCD).

This is of great importance to you, because you are 35 years old. The leading cardiac cause of SCA in athletes is a condition known as hypertrophic cardiomyopathy (HCM), in which the heart muscle becomes very thick and, as it were, muscle-bound. Normal function is impaired.

For the heart to function efficiently, it must be able to eject adequate volumes of blood and to relax well in order to accept an adequate inflow of blood. The thickening of the muscle not only impairs the function of the heart (one would expect muscular hearts to be superefficient) but makes the heart more susceptible to electrical conduction abnormalities, or arrhythmias. Such rhythm disturbances prevent the heart from doing its normal work of providing normal blood pressure and propelling blood throughout the body system. Consequently, there is decreased blood flow to the brain and all body tissues. If this is not urgently treated, death ensues. More than half of the sudden deaths from HCM occur in Black athletes. More than two thirds of young athletes who die suddenly are basketball and football players.

These statistics are drawn from studies on highly trained athletes who do regular vigorous and intensive exercise. Generally, exercise is extremely healthful and is associated with a much lower risk of death in all age groups. It is crucial to avoid and prevent SCA and SCD in all population groups.

Certain risk factors help to identify those who would benefit from screening:

  • a family history of unexplained or unexpected sudden death, especially in younger persons
  • an episode of fainting or convulsion/seizure during exercise
  • unusual or unexplained chest pain accompanied by unusual shortness of breath during exercise

Basic screening tests include careful examination, resting and exercise EKG studies, and an echocardiogram.

If you are still in doubt about your risk, see your physician. Remember, your body has been “fearfully and wonderfully made” (Ps. 139:14), and you have been designed to move. So if tests are needed and all is well—be strong, and just do it!

Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.