While doctors recognise physical exertion and an exercise regimen as the best ways to stay healthy, cardiologists say one has to determine how much is too much. Image Credit: Shutterstock

Dubai: Sajeev Kaura, Indian expatriate in Dubai and a senior business director with an international organisation, now 55, was only 41 when he suffered a heart attack. An extremely fit person with an ideal weight range, he ran five times a week, covering nearly 5-6km each day at an average speed of 10kmph and played golf every week.

Recounting his experience, Kaura said: “I was posted in Johannesburg, South Africa, then. This happened on a Sunday, while I was visiting a friend’s place for lunch. I suddenly felt a pain in my left arm that travelled to my back. I was sweating and was in discomfort, but thought the incident would pass off. But within a few minutes, I felt I had to visit the hospital.”

He was driven to the Emergency Room by his friend where the doctor diagnosed that he was in the midst of a heart attack. “I was taken aback as I had been keeping super fit and healthy and was only 41,” said Kaura, who had to undergo an angioplasty for stent placement in his major artery.

Indian expatriate Sajeev Kaura, now 55, was only 41 when he suffered a heart attack. Image Credit: Supplied

Family history, smoking habit

The reason why Kaura suffered a heart attack could possibly be attributed to his family history of heart disease and his habit of smoking, doctors said. “These were the only two questions that the doctor asked me about. My father who was a non-smoker had his first heart attack at 44. Here I was smoking about 10 cigarettes a day and that would have led to a thickening of my main artery. An angioplasty and stent later, I felt fine,” said Kaura.

Since the incident, Kaura has given up smoking completely and has kept up with his fitness schedule. “I continue to run five times a week, play golf once a week and eat healthy. Two years ago, I ran the half marathon in Ras Al Khaimah. My weight has always been steady. The only thing that is different is that I am now regular with my health and heart check, once every six months. Being physically fit probably saved me when I had a heart attack, as my doctor said it could have been worse,” Kaura added.

What Kaura experienced is not an isolated case. There have been many instances in the last two years of people collapsing with sudden cardiac arrest or suffering an irregular heart rhythm and in many cases with fatal consequences. But what are the risks involved?

Importance of healthy exercising

While doctors recognise physical exertion and an exercise regimen as the best ways to stay healthy, cardiologists say one has to determine how much is too much.

Dr Abdul Rahuman Aboobaker

Dr Abdul Rahuman Aboobaker, consultant cardiologist at Thumbay Hospital, Fujairah, explained: “Regular physical exercise is one of the most important recommendations for keeping healthy, but very vigorous exercise can sometimes lead to a myocardial infarction (MI), arrhythmia and sudden death.”

He said: “The most important cause of exercise-related cardiac events is related to Coronary Artery Disease (CAD) or atherosclerosis. This involves blockage in the main arteries of the heart supplying oxygenated blood. Although the build-up happens very slowly and the disease is said to be silent killer, an atherosclerosis plaque can rupture at any given moment and produce acute block in coronary artery. The precipitating factors could be a habit of smoking, physical or mental stress. Stress is again something that cannot be quantified and its impact varies from individual to individual. The stress of physical exercise is different in different ages and depends on one’s physical fitness status.”

Ajay Chaturvedi

Ajay Chaturvedi, a health sector personnel, qualified Basic Life Support (BLS) and trained to give advanced Cardio Pulmonary Resuscitation (CPR) in emergencies, said as a BLS-trained official, he had worked closely with cases where people had experienced a sudden irregular rhythm or heart attack.

He said: “Exercise-exerted angina is a common phenomenon. The extra strain in the case of an individual who may have a blocked artery can trigger excessive strain on the heart muscle and result in a complete blockage of the artery triggering a cardiac arrest. Most individuals, who are young, never think they may have CVD and may ignore symptoms such as excessive sweating, nausea and dizziness. They presume it is due to heavy exercise or weightlifting, while it may actually be happening because they are experiencing a heart attack.”

So it’s better to be safe than sorry.

Fitness experts say it is important to build up one’s physical fitness slowly and gradually and not indulge in sudden exertion.

There has to be a regular schedule of stretching, breathing and working out, followed by an elaborate cooling-down process that will help prevent any kind of strain to the heart.

Dr Aboobaker said: “One needs to follow the rule of exercising regularly without straining too much. Individuals should follow the thumb rule of getting regular medical checks done. Knowing your body and how much you can stretch yourself is the key requirement before taking up any high intensity workouts. Moreover, there is no one-size-fits-all strategy. More often, people who exercise irregularly and later compensate by vigorous workouts to compensate for the missed period are the ones who face health challenges. Physical exercise should be graded as beginners, intermediate and advanced [to avoid over-exhaustion].”

If the body develops a fever or infection such as COVID-19, one should wait for full recovery before beginning any exercise. It is advisable to start on an exercise regimen, at least two weeks after full recovery and that too graded exercise.

Know the symptoms

If you are exercising and experience any of the following symptoms, stop your workout immediately and seek medical help. Heaviness, chest pain, breathing difficulties, unusual sweating, dizziness, light-headedness and heart rhythm abnormalities are some of the red flags.

Go in for medical evaluation annually

Anybody who plans to follow an exercise programme and is above 40 years, ideally should have consultation with his or her doctor, Dr Aboobaker advised. The individual should undergo an Electro Cardiogram and blood tests to find the risk factors for CAD, diabetes, cholesterol, creatinine etc. If an individual has a family history of heart disease or has occasionally suffered from breathlessness, palpitation, then he or she should undergo an echocardiograph and a treadmill test. In high-risk people with heart diseases or sudden death in the family, a coronary CT angiogram is also recommended.

Sports and heart health

Dr Naeem Tareen, a leading cardiologist in the UAE, those who are active in sports must also be conscious of their heart health.

An American Board-certified cardiologist and fellow at American College of Cardiology and chief of American Heart Centre at the Dubai Healthcare City, Dr Tareen said that even professional sports persons tend to lose fitness once they are out of active sports and can end up suffering heart ailments.

Dr Naeem Tareen

“My message is that, everyone, including athletes and cricketers, should have regular check ups and have electrocardiography stress test echocardiograms and lipid profiles done apart from following a healthy lifestyle,” Dr Tareen said.

He said professional sportspersons are more prone to suffer from heart ailments after retirement because they do not tend to exercise as they used to do earlier.

He said it is important for the general public to see a cardiologist immediately if they have chest discomfort or heaviness in chest or shortness of breath when they are exercising or are engaged in a sport.

“Initially, it happens after exertion or exercise. Some people get indigestion or left arm pain or pain or discomfort in the jaw. All these are warning signs and should not be ignored. General people should watch their weight, quit smoking or shisha. They should also monitor their lipids, that is cholesterol, triglycerides and particularly good and bad cholesterol.”

Dr Tareen said it was important people should also have a tight control of their blood sugar levels because diabetes is a major risk factor. Blood pressure should also be under good control.”

He said lack of exercise too is a risk factor. “I advise my patients to walk daily. Everybody should have annual health checkups.”

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What to do if you experience any uneasiness while exercising?

• Stop exercising immediately and call the emergency medical response number 999.

• Do not dismiss or ignore any visible sign of discomfort such as pain in the arm, uneasiness, palpitation, nausea or dizziness.

• Inform the reception desk and ask for help. If the gym has a paramedic on call who knows how to administer CPR, request for help.

• Call or inform family members; if you have a physician call him or her.

• Open the windows and lie down.

• Loosen your clothes and try deep-breathing.