Royal Brompton & Harefield Hospitals expert explains the link between sport and cardiac conditions

Heart listening with stethoscope

The link between sport and cardiac arrest is one that is often undetected, especially in high-profile athletes. Can high intensity sport cause cardiac events? If you have an undetected cardiovascular condition then it might – but, for the vast majority of people, exercise remains hugely beneficial.

Dr Mark Mason, a consultant cardiologist at Royal Brompton & Harefield Hospitals Specialist Care takes us through a brief overview of the relationship between high intensity exercise and cardiac arrest.

Over the years, a number of high-profile athletes under the age of 35 have been affected by undetected cardiovascular conditions. Fortunately, football player Fabrice Muamba and cricketer James Taylor both survived their cardiac events. However, unfortunately there are fatalities, every year in endurance events such as the London Marathon.

“Affected people under the age of 35 could have an inherited condition – although they may be the first person in their family to experience it” says Dr Mark Mason, based at Harefield Hospital. Broadly, problems result from different types of cardiomyopathy, which affects the heart ventricles. Or, they can result from harder-to-find channelopathies, underlying conditions causing abnormal rhythms in an otherwise normal heart. Most over-35s who experience a cardiac event, meanwhile, will do so because previously undiagnosed coronary artery disease.

Know the symptoms

If you have an undetected cardiovascular condition then longer duration, high intensity exercise could heighten the risk of a cardiac event, particularly in the over-35s. However, Dr Mason stresses, the overwhelming evidence is that exercise is hugely beneficial for the vast majority of people. So yes, it’s important to keep active.

“To put it in perspective, around on in 20,000 exercisers per year have a cardiac event,” says Dr Mason. “instances are probably lower for the under-35s who are generally healthy, and a bit higher for those over 35 with underlying cardiovascular risk”.

Symptoms can include shortness of breath, lightheadedness or blackouts, heart palpitations or chest pain. “These could feel like tightness, heaviness, or the sensation of having a belt being tightened around your chest,” says Dr Mason.

Make lifestyle changes

Over-35s can reduce their risk of cardiovascular disease by eating a healthy diet and cutting out smoking. In the under-35s, however, reducing the risk of a cardiac event is more challenging – particularly if you don’t know you have a problem to begin with. “Then we get into the contentious issue of mass screening programmes,” says Dr Mason, which some countries have adopted.

In Italy, anyone between the ages of 16-35 has to undergo screening (by law) before participating in sport at any level. “As a result, it’s estimated that Italy has reduced its instances of cardiac events by around 90%,” says Dr Mason. However, as high profile cases such as Piermario Morisini and Davis Astori show, there is still a risk.


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