The Hay­wire Heart: How too much ex­er­cise can kill you, and what you can do to pro­tect your heart

Triathlon Magazine Canada - - GEAR - POW­ERS

Chris Case, John Man­drola, MD and Len­nard Zinn Velo­press 2017

When you saw this book ti­tle, maybe you thought, “That can’t hap­pen to me, I’m in re­ally good shape.” Well, not to scare you, but de­nial is a com­mon re­sponse from en­durance ath­letes who do, in fact, have heart prob­lems. So, par­tic­u­larly if you are over the age of 40, this could be a life-sav­ing book that tells you how to stay ac­tive, but not dam­age your heart.

The au­thors em­pha­size they are not alarmists and all were long-term en­durance ath­letes un­til two of them de­vel­oped heart ar­rhyth­mias. Dis­cov­er­ing there were many other ath­letes with the same dilemma, they be­gan ex­ten­sive re­search to learn why this was hap­pen­ing.

What is a hay­wire heart? Gen­er­ally hay­wire de­scribes some­thing er­ratic – here that means ar­rhyth­mia, a con­di­tion of faulty heart­beat tim­ing. Heart mus­cle cells func­tion through the smooth trans­mis­sion of elec­tri­cal sig­nals – like a wave of com­mu­ni­ca­tion that helps con­trol heart rhythm. Dam­age to the heart can dis­rupt this com­mu­ni­ca­tion process and then it won’t work prop­erly.

Keep in mind this book is not about “nor­mal” ex­er­cise lev­els but “a highly el­e­vated level of ex­er­cise that is not only ex­tremely in­tense but of­ten com­pet­i­tive and is per­formed for years, if not decades.” There is grow­ing ev­i­dence that en­durance ex­er­cise in­creases the risk of heart rhythm dis­or­ders and that re­duc­ing train­ing in­ten­sity and/or length of­ten fixes the prob­lem. Dam­age can oc­cur be­cause of ex­treme fluc­tu­a­tions be­tween very high and very low heart rates, in­flam­ma­tion, scar­ring and stretch­ing that fre­quently take place in the ath­letic heart.

De­tailed case stud­ies ex­plain that hav­ing an iden­tity as a high-per­for­mance ath­lete can make it dif­fi­cult to ac­cept that there might be a prob­lem. Au­thor John Man­drola is a car­diac elec­tro­phys­i­ol­o­gist who has seen ath­letes push through se­vere symp­toms of dis­ease.

“It’s re­mark­able what an ath­lete can ig­nore,” he says. “It’s im­pos­si­ble to quan­tify one’s pain thresh­old, but heart dis­ease can come on slowly. The stealthy creep of heart dis­ease can blend with sto­icism to mask im­por­tant symp­toms. Be mind­ful of this. It’s real.”

Mike Endi­cott com­pro­mised his health with a very busy life­style of work and com­pe­ti­tions that sud­denly took him out of a ski marathon. Feel­ing dizzy and drunk, he was hy­per­ven­ti­lat­ing and could hardly stand up. Yet the 50-year-old was ly­ing in a snow­bank, feel­ing frus­trated about his un­ex­pected change of plans: “I had work to do that af­ter­noon, phone calls to make. It just wasn’t on my list of things to do – to die on the ski trails.” It took months to find a med­i­cal treat­ment that helped and al­though he re­sisted for a long time, he fi­nally ac­cepted his sit­u­a­tion and adapted a health­ier life­style.

Heart prob­lems can in­volve many con­tribut­ing fac­tors and, over­whelm­ingly, these au­thors be­lieve that phys­i­cal ex­er­cise is a pos­i­tive thing. How­ever, from the per­spec­tive of their per­sonal ex­pe­ri­ence and knowl­edge, they urge ath­letes to be re­al­is­tic about the dan­ger of push­ing the lim­its of your heart.—he­len

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