The start of the year—whether calendar or school year—sometimes means getting back into sports, which is good for the body but not always without risks, particularly for the heart.
The start of the year is also a time for new resolutions. This is often the time when people start or resume a sport, either in a club or on their own. This is usually an excellent idea: the benefits of exercise on the body and mind are well established. And for the heart in particular: better blood flow, the heart rate slows down, putting less strain on this organ, and these are just some of the positive effects of exercise. But it is also important to bear in mind that it is not without risk for some people, and that it can reveal or aggravate heart rhythm disorders.
When practicing a sport, many variations in heart rate can occur. The heart may beat too fast, too slow, or irregularly. These dysfunctions can be benign, but sometimes they can be serious, leading to loss of consciousness or cardiac arrest. Every year in France, an estimated 800 amateur athletes and around 15 professionals are affected. This can sometimes have a considerable impact when top athletes suddenly collapse during competition, victims of sudden cardiac death.
Reducing risk factors
So how can heart rhythm disorders be prevented in athletes? First, by eliminating or taking certain risk factors into account. These include a family history of sudden cardiac death or heart disease. This does not mean that exercise should be avoided in these cases, but that it should be closely monitored. Dehydration, lack of sleep—deep sleep phases are crucial for regenerating the heart muscle—overwork, and certain associated conditions, such as high blood pressure or sleep apnea, can also increase the risks. Taking stimulants, or worse, performance-enhancing drugs, should be avoided if you want to protect your heart.
In general, a healthy lifestyle is essential: a balanced diet rich in fruit, vegetables, and omega-3 fatty acids contributes to cardiovascular health and in particular for athletes. Limiting alcohol and smoking is essential. Rest and recovery, which professional athletes often refer to as “invisible training,” must be an integral part of the program. Alternating intensity and gentle endurance, taking days off from sport, and avoiding overtraining are all protective measures.
Under medical supervision
Prevention also means, of course, undergoing appropriate medical monitoring. This does not simply mean obtaining a medical certificate stating that there are no restrictions on participating in sports, but rather undergoing a full cardiac assessment, including an electrocardiogram (ECG), cardiac ultrasound, and stress test. Reducing risks also means seeking immediate medical attention in the event of unusual symptoms, such as palpitations, discomfort, unexplained shortness of breath, and chest pain.
Technology can be very useful in identifying these symptoms. Smartwatches and heart rate monitors now offer athletes real-time monitoring tools. They can detect abnormalities in heart rate at rest or during exercise. Some apps even alert you if they suspect arrhythmia. While these tools are no substitute for a medical diagnosis, they are a valuable help in detecting early warning signs.
Eventually, during the training itself, there are some best practices to keep in mind: gradually increasing the intensity, for example. It can be tempting to pick up where you left off a few years earlier, assuming that you are capable of repeating the same performance. You need to give your body time to return to a level close to what you were used to, while accepting the idea that you may not be able to get back to that level. You also need to respect recovery phases: rest is a key part of prevention. It is best to vary your activities: combining endurance, muscle strengthening, and flexibility training helps to balance the demands on your body. Finally, warm up and stretch properly to prepare your cardiovascular system for exercise.
Upcoming progress
Once all these precautions have been taken, are we safe from heart -related issues during sports? Obviously not. There are cases where weaknesses cannot be detected in advance and can cause the death of athletes in the prime of life. “It is not a random or temporary factor that kills these young people. It is a pre-existing microscopic lesion in the heart tissue, which is extremely serious but undetectable during conventional examinations. Just a few grams of damaged heart tissue are enough to trigger these sudden cardiac deaths,“ explains Professor Michel Haïssaguerre, cardiologist and rhythmologist at the IHU Liryc. ”The paradox of these unexplained sudden deaths is that there are devices available to prevent them, in particular implantable defibrillators. However, we still need to be able to identify those at risk. At present, there is no way of detecting them,” except by performing extremely invasive tests on people who appear to be in good health. In any case, this is the state of the art “today,” as Professor Haïssaguerre points out. But to prepare for tomorrow, the teams at IHU Liryc are trying to develop an extremely accurate ECG that can detect these micro-alterations.
