How cardiologists help professional and recreational athletes train safely

The heart is consistently working to keep our bodies moving, and even more so during competitive and recreational activity. As Dr Sabiha Gati (a leading UK consultant cardiologist) clarifies in this article, many people can receive vital help and advice after undergoing cardiovascular screening. Read on to learn how you could benefit.

Do cardiologists work with top-level athletes only?

No, we support athletes of all levels. Our goal is to minimize the risk of heart problems that are associated with the most intense sporting activities and a strenuous athletic lifestyle.

We provide expert advice, cardiac screening and assessment for both competitive and recreational athletes and for those of all ages and abilities who would like to start exercising again.

Professional and elite athletes

We work with professional athletes from regional, national club and international levels - from all sporting disciplines.

Recreational athletes

Most of the exercising population perform leisure sports and might take part in solo recreational exercise. Some people who take part in recreational exercises such as running and cycling probably do a greater amount of exercise compared to most competitive athletes involved in skilled sports.

Veteran and master athletes and those with pre-existing cardiac conditions

A significant amount of people who exercise are middle-aged and older. What’s more, they might harbour age-related cardiac diseases including hypertension (high blood pressure), ischaemic heart disease (also called coronary heart disease), atrial fibrillation and valvular heart disease. Regular physical activity, including systematic training, is an important part of therapy for a lot of people in this group.

Physicians are increasingly being met with questions about participating in exercise and recreational sports activities from patients who already have established risk factors for coronary artery disease or established cardiovascular disease. Also, in an era of rising  obesity and diabetes cases, promoting regular physical activity is even more relevant.

With a cardiologist’s input, all of the above groups can benefit from appropriate encouragement, advice and an individualised exercise prescription to suit their personal needs and goals.

When should an active person see a cardiologist?

Active people can visit a cardiologist at any stage of their life or career.

Younger age group

In young people (those below 35 years old), the most common causes of sudden death are congenital abnormalities of the heart, electrical abnormalities of the heart rhythm (‘cardiac arrhythmia syndromes’) and heart muscle conditions (‘inherited cardiomyopathies’). However, most of these conditions can be diagnosed throughout a young person’s life via screening and there are several strategies to minimise the risk of sudden death.

Older and middle-age groups

Generally, older and middle-aged individuals over the age of 40 are at risk of coronary artery disease. This is the most common cause of exercise-related heart problems. Alternatively, they may already have an underlying disorder such as hypertension, atrial fibrillation or valvular heart disease.

Consequently, we would also recommend that people with pre-existing cardiac conditions who want to begin a new active lifestyle have a detailed evaluation to minimise their risk of heart problems.

Who is a cardiac screening recommended for?

Cardiac screening is suitable for everyone. For example, if you’re in one or more of the following scenarios:

1. You have no symptoms of a heart condition but a family history of sudden death, ischaemic heart disease or heart muscle conditions; we can help you evaluate your personal risk.
2. If you’re had no previous health concerns but would like peace of mind before taking up an active lifestyle and/or competitive sports.
3. You’ve been given an abnormal electrocardiogram during a routine medical.
4. You have a pre-existing condition and would like it checked and managed.
5. You’re experiencing symptoms like chest pain, breathlessness or palpitations (a racing heart) during exercise (or also without having done exercise) and need to find out the cause.

What can I expect during a sports cardiology consultation?

We (cardiologists) would arrange an electrocardiogram (ECG) (an electrical trace of the heart) and an echocardiogram (an ultrasound scan of the heart structure and function).

Occasionally, further tests may be required. These may include running on a treadmill or bicycle ( exercise stress test ), prolonged ECG monitoring and a cardiac magnetic resonance (CMR) for a detailed evaluation of your heart’s structure and scarring within the heart muscle. For older patients, this would also include a blood test to check their triglycerides and cholesterol analysis.

Once the tests are completed, your cardiologist would talk you through the results and, more importantly, guide you through your personalised exercise prescription. This prescription is based on:

• The results from the assessment of your underlying heart condition.
• If you have symptoms.
• Your general condition and other medical problems that you have.
• Your established risk markers for a future heart problem.

Are you looking for an expert in sports cardiology? Dr Gati can help you achieve your optimum heart health – learn more and book your video or face-to-face consultation.