With marathons, CrossFit, and endurance challenges like Hyrox gaining popularity across India, more people are pushing their bodies to new limits in pursuit of fitness. While regular exercise is, without doubt, excellent for long-term health, experts caution that before transitioning from recreational activity to high-intensity training, it is crucial to ensure that your heart is ready for the challenge.
The physically demanding nature of these events makes them significantly stressful for the cardiovascular system. Although the vast majority of athletes are healthy, a small proportion may unknowingly have underlying heart conditions that can become life-threatening during strenuous activity. These conditions may be inherited, such as hypertrophic cardiomyopathy, a genetic disorder that causes abnormal thickening of the heart muscle, or acquired, including coronary artery disease caused by blockages in the heart’s arteries. Unfortunately, many of these conditions remain silent until triggered by intense physical exertion.
Reports of seemingly healthy individuals collapsing in the gym often point to underlying cardiac disorders that had gone unnoticed. The risk is particularly relevant for people who are starting from scratch. A sedentary office worker training for their first marathon or someone taking up competitive sports after years of limited physical activity places their cardiovascular system under sudden and significant stress.
A pre-participation cardiac evaluation can help identify any issues. The assessment typically begins with a consultation with a cardiologist, who will evaluate personal and family medical history, symptoms, and overall cardiovascular risk. Routine investigations may include blood tests to assess cholesterol, blood sugar, thyroid function, high-sensitivity C-reactive protein (hs-CRP), and lipoprotein, all of which provide valuable insights into cardiovascular health. Depending on the individual’s risk profile, additional investigations such as an electrocardiogram (ECG), echocardiogram, treadmill stress test, coronary calcium scoring, or, in selected cases, coronary angiography may be recommended.
For individuals with a family history of sudden cardiac death or inherited heart disease, prolonged heart rhythm monitoring known as Holter monitoring, may help detect abnormal heart rhythms that routine tests could miss. In situations where structural abnormalities are suspected, cardiac MRI offers detailed imaging that enables timely diagnosis and appropriate treatment planning.
Cardiac screening enables safe training by identifying potential risks early and ensuring that any underlying condition is managed appropriately before embarking on intense physical activity. Regular exercise remains one of the strongest pillars of good health. However, when preparing for endurance events or competitive sports, a timely cardiac checkup will ensure that your heart is as fit as your determination.
Dr. Pradeep Haranahalli, Consultant – Interventional Cardiology at Manipal Hospital Whitefield.