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To prevent cardiac events during working out


Cardiac events during working out

Have you ever heard such news reports as, “He or she had a heart attack while exercising and was saved by chest compression”? As a cardiologist, I sometimes was in charge of patients transported to the hospital because of heart attacks during exercise. The causes were myocardial infarction and arrhythmias other than myocardial infarction1.

Myocardial infarction during working out

Myocardial infarction, so-called heart attack, is a condition where cholesterol accumulates in the three blood vessels that supply oxygen to the heart, causing a blood clot to form and suddenly block the flow of arterial blood. It is characterized by symptoms such as tightness or pain in the chest when walking or carrying heavy objects, and the pain may radiate to the neck or jaw. Detectable warning signs during light exercise are favorable, but unfortunately, there can be no premonitory symptoms. It can strike suddenly during physical activity and lead to cardiac arrest in the worst-case scenario.

However, there have been reported cases of triathlon athletes in their 40s who experienced no warning signs during intense training before competitions. He could complete the swim and cycling but experienced cardiac arrest during the final jog, resulting in a myocardial infarction. (See below the link 2)

Acute Myocardial Infarction During the Last Part of a Triathlon: A Case Report Triathlon has a risk of sudden cardiac death (SCD) for athletes. Most SCDs during endurance sports in adult athletes are due to coronary artery disease but ofte...

To prevent cardiac events during working out

Certain conditions can be identified through pre-exercise testing. However, scientific evidence from large studies is lacking because it’s rare among young athletes. Does this fact mean individuals with lifestyle-related illnesses, including diabetes mellitus or hypertension, can begin working out without any testing? Particularly athletes with diabetes might have angina without any symptoms. Therefore, whether you are starting or continuing exercise, considering undergoing testing could be a reasonable option.

Additionally, the location and environment for exercising are also crucial. Athletes who are trained in basic life support (BLS) can respond to sudden cardiac arrest, access automated external defibrillators (AEDs), and contact emergency medical services (EMS). Considering the risk of cardiac events during working out, prevention strategies are equally important, in collabolating cardiologists.

In summary

If there are symptoms such as chest pain during exercise, it is possible to conduct tests in order to assess the risk.
While exercise has beneficial effects on managing lifestyle-related diseases, it is crucial to create an environment that ensures safety and peace of mind during physical activity.


  1. Wasfy, M. M., Hutter, A. M., & Weiner, R. B. (2016). Sudden Cardiac Death in Athletes. Methodist DeBakey Cardiovascular Journal, 12(2), 76–80.
  2. Yamaguchi, S., & Shimabukuro, M. (2022). Acute Myocardial Infarction During the Last Part of a Triathlon: A Case Report. Cureus, 14(12), e32768.
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