World Heart Day: Doctor explains tests to be done before heading to the gym

For the past few years, incidents of youngsters collapsing in the gym, despite being active and fit, have become quite regular. From celebrities to common people, all age groups have become prone to this. While social media and conspiracy theories blame many things, from certain dishes to the COVID vaccine, the medical world begs to differ.

On World Heart Day (September 29), Dr Ramdas Nayak H, Senior Consultant and Head of Cardiac Sciences at the Mar Sleeva Medicity, Palai, sheds light on the matter.

Why the sudden collapse
Dr Ramdas says there are multiple reasons for seemingly fit youngsters collapsing in the gyms. They are:
a) Overdoing exercises
When a person works out, they should be mindful of their body's limits, says Dr Ramdas. "Just because X is doing an exercise, Y might not be able to do the same. Moreover, beginners should not try to mimic weights or workouts done by seasoned fitness enthusiasts at the gyms. Workout intensity should only be increased progressively and slowly," he explains.

b) Silent heart diseases
The doctor says that heart diseases can remain within us silently. "They can be triggered over time due to multiple reasons, like excessive workouts. A heart blockage, which has been in our system silently for a long time, can at times suddenly get triggered when a person goes beyond their regular level of exercise," he says.

c) Ignorance of one's heart condition
Often, people might not have done enough checks before starting a gym routine to figure out whether their heart can handle it, the doctor observes. He explains:
a) The person might not have checked their blood pressure recently.
b) The person might be working in a stressful atmosphere.
c) The person might not have done regular blood checks.
d) They might have a family history of heart disease.
e) The person might be a smoker.
f) The person might be using stimulants like caffeine regularly.
All of these can contribute to cardiac issues, which can appear as a sudden onset of heart disease, says the doctor.

Who is a youngster?
A person is considered a youngster during the productive years of their life, says Dr Ramdas. "In the current era, it can be generally between 28 and 58. That said, in the past, heart diseases used to appear generally after the age of 40. Now, more and more people are coming to us at younger ages, say, from 25 onwards," he says.

What does family history mean?
A person is said to have a family history of heart disease if any of their close blood relatives - father, mother, siblings, uncles or aunties had a heart condition. "If an individual's first-degree relatives, mentioned above, have done angioplasty under the age of 65, had heart attacks, a bypass surgery or stroke, they are considered to have a family history of heart disease," says Dr Ramdas.

Standard lab results can miss hidden genetic elements
Dr Ramdas points out that for a person with existing risk factors for heart issues, the 'normal' range mentioned on a lab test might not apply to. They will have to consult a physician or cardiologist to analyse whether their results are normal, considering the other factors. "For instance, if a person has risk factors like family history of the disease, abnormal hba1c levels, the habit of smoking or high blood pressure, their 'normal' isn't the one given in the lab report. Your doctor can help you interpret the report and take corrective measures, factoring all these aspects in," he says.

What tests should be done before joining gym?
If a person intending to join the gym has a family history of heart disease, or is a smoker or drinker, has high blood pressure, borderline blood sugars or any other risk factors, do the following tests after speaking to your doctor, before starting the training:
a) Haemoglobin Test
b) Lipid Profile
c) Other required blood tests (As per doctor's advice)
d) Blood Pressure Reading
e) Echo test
f) Treadmill Test
g) CT calcium score

Does a positive treadmill test mean the heart is completely healthy?
Interestingly, it is a no, says Dr Ramdas. A 'normal' treadmill test doesn't rule out heart disease. Moderate blocks need not show up during a test. However, during stressful situations, they can still rupture, leading to a heart attack.

What is CT calcium score?
It's a simple five-minute test in which an individual lies down on a CT scanner table and holds their breath for a few seconds, after which they get the calcium score. Dr Ramdas explains, "The heart is a muscle, and there is no calcified plaque around it. So, if a person's calcium score is 0, there is no need to worry. The chance of them having a heart attack in the next one year is 1 in 10,000. If the score is more than zero and less than 100, the chance is one in a thousand. From 100 to 400, the chance is one in 100. Anything above 400 means they are likely to have a block. Anyone who has more than 100 can also have risk factors. If a person's score is between 100 and 400, they should ideally undergo a coronary angiogram or CT angiogram."

CT score result interpretation
0 - No amount of calcified plaque
0 to 100 - Minimal amount of plaque. The individual should be cautious and start with a proper diet and exercise. They should also do blood and treadmill tests every year.
100 plus - Moderate amount of calcified plaque. They can be advised to have a CT or Coronary angiogram
Above 400 - Extensive amount of calcified plaque. They should meet a cardiologist and get an angiogram

Are COVID vaccines responsible for heart issues?
The doctor says it's a total myth. "There are many studies that say the COVID vaccine itself doesn't cause heart disease. That said, the COVID virus is the biggest cause of blood clot formation," he explains. "The chance of having blood clots if you have a COVID infection, especially if you had it twice, is 16 to 20%. The chance of a COVID vaccine resulting in a blood clot is just 0.0004 per cent. A person who smokes has a 0.16 per cent chance of having a blood clot, and a lady who takes oral contraceptives has the chance of having it 0.12 per cent," he says.

What foods to avoid for a healthy heart?
Dr Ramdas says it's better to avoid the regular consumption of the following foods for a healthy heart:
a) Oily foods
b) Junk foods
c) Long-refrigerated foods
d) Red meat
e) Sugar
f) Tapioca
g) Kerala porotta
h) Excessive rice

The best foods for heart health
Dr Ramdas recommends including the following in our diets for a healthy heart:
a) Fruits
b) Vegetables
c) White meat like chicken, turkey
d) Egg whites (2/3 yolks a week is alright)