Exercising with a heart problem can put harmful strain on the body if physical limits are exceeded. Additionally, people taking part in strenuous physical activity might not know they have a heart condition.

Our sports cardiology service supports people with heart problems to understand their limits and achieve their fitness goals. They can also diagnose silent heart conditions to ensure everyone can safely enjoy the benefits of physical activity.

Exercising with a heart problem can be stressful

Exercise has many well-known health benefits. In addition to reducing the risk of developing further heart problems, it improves the cardiovascular and musculoskeletal strength of your patients. Additionally, it benefits their mental wellbeing.

However, starting or continuing physical activity after being diagnosed with a heart condition can be worrying. Patients may be concerned about the strain they are placing on their hearts. They may also be uncertain of their limits. “Many patients with heart disease are naturally worried about strenuous exercise. This is particularly true for patients that have had a recent intervention,” explains Dr Sabiha Gati, consultant cardiologist and specialist in sports cardiology.

“By conducting an advanced assessment of their heart, we can develop a tailored exercise plan. This gently reintroduces them to physical activity and helps with their fitness goals. This lowers their anxiety and ensures they can enjoy exercise once more.”

Exercise is recommended, even with heart conditions

The European Society of Cardiology recommends 150 minutes of moderate intensity exercise each week for people with heart conditions. This is the same as the guidance for healthy adults of all ages.

Studies have shown that people who have had a heart attack and become more physically active afterwards have a 50% reduced risk of dying within four years. Research has also shown that regular exercise in patients with coronary heart disease can reduce their risk of heart failure.

However, there is a small chance that exercise can trigger a sudden cardiac arrest in people with advanced heart disease.

Medications to treat heart disease can also affect how the body responds to exercise and performance. “We want everyone with a heart condition to enjoy the benefits of physical activity. A sports cardiology assessment can help us identify their level of risk with different activities to ensure they can safely participate.”

Heart conditions are not always known before exercising

The most common cause of exercise-related heart problems is coronary heart disease. People over the age of 40 are most at risk but they may not know they have the condition before exercising.

Training before taking part in an endurance event, like a marathon, can help protect people from injury. However, studies have shown that training may not always prevent a sudden cardiac arrest during a marathon. It is likely that training does not put the body under the same strain as the race itself. This is because participants would typically run for longer. It is thought that the strain on the body while running long distance can increase the chance of blood clots forming in the heart.

While the risk of a sudden cardiac arrest increases with longer races, they can occur in shorter races too. This includes half marathons. “We advise anyone over the age of 35 with an inactive lifestyle and heart risk factors to get a heart check before taking part in an endurance challenge,” says Dr Gati. “This ensures we can capture any silent heart problems before they take part in exercise that can cause significant strain.”

Heart risk factors include a history of smoking, a sedentary lifestyle, high cholesterol, or high blood pressure. It can also include conditions such as diabetes and a family history of heart disease.

Expert sports cardiology assessments

Our sports cardiology service at Guy’s and St Thomas’ Specialist Care is world-renowned. Our consultants provide heart care for competitive and recreational athletes of all ages – from adolescence to later in life.

Our multidisciplinary team includes world-leading cardiologists, cardiac surgeons and medical imaging specialists. Together, they diagnose and treat a range of heart conditions that can affect exercise performance. This includes structural heart problems present at birth, arrhythmias and heart diseases that appear later in life such as coronary heart disease. It also includes conditions that put a strain on the heart like diabetes and hypertension.

Additionally, our team of experts includes respiratory physicians specialising in sports medicine. This enables us to review heart and lung problems together to determine how they affect exercise performance. “Our multidisciplinary team provides a holistic approach to reviewing your patients’ level of heart risk with exercise. Together, we can help them achieve their fitness goals,” says Dr Gati.

Our sports cardiology assessments start with an initial assessment to understand the level of heart risk during exercise. Heart checks include an exercise stress test to help determine how your patient’s heart works with physical activity. Tests may also include a cardiac MRI to understand if there is any scarring of the heart muscle.