Who is prone to heart attacks while gymming? Doctor explains how to monitor heart, stay safe

A Kochi man died of cardiac arrest on Wednesday (July 30) while exercising at the gym. The 42-year-old is the latest individual among many health-conscious youngsters who exercised regularly and yet suffered from sudden, unexpected cardiac arrests. A few months ago, a 20-year-old in Wayanad had also similarly lost his life. Why are many youngsters suffering from heart attacks while working out, which is presumed to be a healthy activity? Are intense workouts to blame, or is it due to a health condition they haven’t discovered? Dr Deepak Davidson, Chief Interventional Cardiologist at Caritas Hospital and Heart Institute in Kottayam, Kerala, explains:

When are you at heart attack risk while working out?
According to Dr Deepak, in the case of those above the age of 40, the individuals with the following conditions are prone to develop heart attacks during a gym workout, if they have underlying, asymptomatic heart diseases:
1) A family history of heart disease
2) Diabetes
3) Hypertension
4) Cholesterol
5) The habit of smoking

He explains, “Suppose an individual is 50 years old and has a small block of 60 to 70% inside the person’s heart. They might not be aware of it if they had no symptoms of it.” Why did the block develop in the first place? “It can be because of the person’s diabetes, hypertension or the habit of smoking. These reasons can make them a high-risk candidate to develop a block.” The doctor says that if this person goes to a gym and does aggressive exercise, they can develop a heart attack. “The 70% block can suddenly become a heart attack. Therefore, gym goers above the age of 40 or 45 years, if they have an asymptomatic heart disease related to their risk factors, can be prone to develop a heart disease,” the doctor says.

When is a person under 40 at heart attack risk while working out?
The doctor says it’s an infrequent occurrence. “In the case of marathon runners, the number of such deaths is estimated to be 1:1 lakh. As for gym goers, there is no such data available.” However, particular youngsters can have a heart attack during aggressive gymming or badminton and this is due to rare diseases like Arrhythmia ( a condition in which the heart beats irregularly), Channelopathies (Diseases due to defects in ion channels of the body) or Cardiomyopathy (Heart muscles find it challenging to pump blood efficiently), says Dr Deepak. “Many won’t be aware that they have the condition. However, when they work out aggressively, these conditions can cause death. Though they are rare occurrences, we learn about them, thanks to social media,” says Dr Deepak.

Are you prone to a heart attack while working out?
Suppose you are a person above 40 and have a family history of cardiac diseases, diabetes, hypertension, high cholesterol levels or the habit of smoking. In that case, you can be at risk of heart disease while working out, the doctor says. Therefore, before engaging in aggressive workouts, it’s necessary to evaluate these health parameters. “Go for basic workouts and quit habits like smoking. Also, tests like ECG, Echocardiogram and Treadmill tests can give a clearer picture to help you with safe gymming,” Dr Deepak explains.

However, it’s challenging to identify whether a person under 40 can be prone to heart attacks while working out. “That said, if a person has a family history of sudden cardiac deaths, like a sibling or cousin who passed away young due to such a condition, it’s possible that they too have the rare disorder. Therefore, doing health check-ups can be helpful before engaging in demanding workouts,” the doctor says.

How to be alert while working out?
While exercising or running, if a person experiences excessive breathlessness, unusual discomfort, palpitations, blackouts, giddiness, or chest discomfort without pain, they should stop the activity and evaluate their health, says the doctor.

How else can you check whether your exercise is cardiac safe?
1) Monitor your heart rate with a smart watch.
2) Your ideal heart rate while working out can be identified with the formula 220 – your age. For example, if your age is 52, your maximum heart rate should be 220-52 = 168 bpm (beats per minute). During regular activities like walking, the heart rate should be between 50 and 70. If you want to go beyond that, make sure you have someone to support or train you.

3) If you are over the age of 50, your maximum heart rate, while running or working out, should not cross 170.
4) If you are a person who starts with your fitness training routines at the age of 40, your heart rate during the training should be around 50 to 70% of your target heart rate. For example, if your target heart rate is 170, your 50 to 70% would be around 90 to 120 during any aerobic workout.
5) Be aware of the various heart rate zones:
Zone 1 – 50 to 60% of your Maximum Heart Rate (MHR)
Zone 2 – 60 to 70% of MHR
Zone 3 – 70 to 80% of MHR
Zone 4 – 80 to 90% of MHR
Zone 5 – 90 to 100% of MHR (Only for athletes into high-intensity training)
Try to limit your heart rate to zone 1 or 2 during various aerobic workouts. The above need not be generally applicable to those under the age of 25, but only those starting with exercises at the age of 40 to 45, Dr Deepak explains.