Many cardiac arrests occur in arenas, recreation centers, fitness centers, and during running events. In recent years, many people have heard that too much physical activity could be harmful to heart health. But what is the reality?

Cardiologist James O’Keefe and his colleagues hypothesized in 2012 that excessive vigorous exercise could have harmful effects on the heart and might predispose individuals to the early development of arrhythmias such as atrial fibrillation, as well as promote the calcification of the coronary arteries. This phenomenon would mainly occur in athletes training for extreme endurance events such as marathons, ultramarathons, triathlons, IRONMAN competitions, and long-distance cycling events. These effects would be temporary for athletes preparing for a single event. However, for those who repeatedly participate in such events and train over many years, this could lead to myocardial fibrosis affecting the atria, the right ventricle, and the major arteries.

However, even though it is clear that vigorous exercise can have effects on the heart, there is no evidence that it increases mortality. On the contrary, several more recent studies have shown that compared to a sedentary population, endurance athletes—despite certain cardiac abnormalities—experience an increase in longevity of up to three years.

It is also important to understand that in the general population, the risk of developing coronary artery disease increases after 55 years of age for men and 65 years for women. The risk of sudden death (cardiovascular event) during physical activity exists for anyone with underlying coronary disease. Therefore, sudden death can occur in both sedentary and active individuals who subject their bodies to an effort that is too demanding. For an active person, this effort might be running a marathon, while for a sedentary person it could simply be shoveling snow.

Furthermore, the number of deaths occurring during endurance events remains extremely low. The rate is estimated at 0.54 cases per 100,000 runners during marathons and half-marathons between 2000 and 2010 in North America.

Cardiologist Éric Larose summarizes the situation well:

“When a person performs vigorous and sustained exercise for several hours, such as running a marathon, the stress it places on the body increases the risk of experiencing a cardiac problem, and that risk is higher than when the person is sitting in a chair at home. However, over the course of a lifetime, this activity extends life expectancy much more than if the person were sedentary.”¹

In conclusion, it is important to be aware of warning signs of cardiac arrest, whether you are active or not. If your heart beats irregularly or unusually fast, if you experience abnormal shortness of breath, or if you feel chest pain that disappears when you stop exercising, it is important to consult a physician for proper evaluation.

For any other musculoskeletal issues, do not hesitate to consult your physiotherapist so you can continue practicing your sport at full capacity.

 

Antoine Vandal

Physiotherapist and running enthusiast

Évolution Physio Clinic, Blainville

 

¹ https://www.kmag.ca/pdf/KMag29_numerique.pdf