Heart Attack During Exercise: Not a Big Threat

Sudden cardiac arrest in middle-aged adults occurred rarely during exercise and was more survivable than other heart attacks

(RxWiki News) Heart attacks can strike with no warning, even while exercising. However, middle-aged adults shouldn't be afraid to exercise, as the likelihood of sudden heart attacks may be low during vigorous activity.

A new study found that a low number of sudden cardiac arrest events occurred during sports activity. Those sports-related cases also had higher rates of survival than other cases.

"Exercise is helpful in remaining healthy, especially as it relates to keeping weight, blood pressure, and cholesterol under control," said Jeffrey M. Schussler, MD, an interventional cardiologist at Baylor Heart and Vascular Hospital and Baylor University Medical Center at Dallas, in an interview with dailyRx News. "Exercise does not eliminate the chance of having a cardiac arrest, but it does afford some advantages. For example, if you have a cardiac arrest in full view of other sport participants, there is much quicker medical attention."

Dr. Schussler continued, "In general, patients who exercise regularly are healthier, and have a higher likelihood of surviving the event. Since it doesn't make the risk of heart disease zero, it's still important (even if you exercise) to watch your cholesterol, treat conditions such as diabetes and hypertension, and see your physician if you're having symptoms such as chest pain."

Sumeet S. Chugh, MD, of the Heart Institute at Cedars-Sinai Medical Center in Los Angeles, led this study.

"Our study findings reinforce the idea of the high-benefit, low-risk nature of exercise in middle age," Dr. Chugh said in a press release.

Dr. Chugh and team studied more than 1,200 cases of sudden cardiac arrest (SCA) that occurred between 2002 and 2013 in the Oregon Sudden Unexpected Death Study. All of these cases involved patients between 35 and 65 years old.

Only 63 cases of SCA occurred during sporting activities. SCA is a sudden loss of heart function that stops blood flow to the heart.

Of the sports SCA cases studied, 45 occurred during activity, while 14 occurred within one hour of the end of activity.

More than half of the cases (58 percent) occurred inside sports facilities. The most common activities linked to sports SCA cases were jogging (27 percent), basketball (17 percent) and cycling (14 percent).

Dr. Chugh and team found that men were over 18 times more likely to have sports-related SCA than women.

Sports SCA cases were more likely than other SCA events.

Overall, 23 percent of patients with sports-related SCA survived to hospital discharge. Only 13 percent of nonsports SCA patients survived to hospital discharge.

Dr. Chugh and team found that most patients with sports-related SCA cases had at least one risk factor for heart disease.

Dr. Chugh and team noted that "the findings from this study should in no way discourage patients with ... risk factors from engaging in regular, appropriate physical exercise within a framework of simple guiding rules from the treating physician."

Patients with heart disease risks or established coronary heart disease should seek counseling when choosing to exercise.

"For any kind of preventative intervention, education is very important and can be more efficient when provided in a targeted manner," Dr. Chugh said.

This study was published April 6 in Circulation.

Grants from the National Heart, Lung and Blood Institute funded this research. Dr. Chugh and team disclosed no conflicts of interest.

Review Date: 
April 6, 2015