Although exercise is usually good for the heart, there are some conditions that are associated with exercise-induced heart disease. The most common of these is coronary artery disease. This is the most frequent cause of exercise related heart problems in adults of middle age and above. Coronary artery disease is particularly common in smokers and in people with a family history of heart attacks (“myocardial infarction”) or elevated blood cholesterol (“hypercholesterolaemia”).

In younger adults and teenagers there are a variety of uncommon heart conditions which can lead to major heart problems on exercise. These include abnormalities of the heart muscle (“cardiomyopathy”), abnormalities of the heart structure (“congenital heart disease”) and abnormalities of the heart rhythm (“cardiac arrhythmia syndromes”). These conditions can occasionally present for the first time in older adults. Most of these conditions can be diagnosed by a combination of a careful family and medical history, an electrocardiograph (ECG) and an examination of the heart structure using ultrasound (echocardiogram). Occasionally, additional tests such as prolonged ECG testing or measurement of the heart rhythm while running on a treadmill (exercise ECG stress test) are necessary.

Dr Ubaid provides an comprehensive, consultant–based assessment service for the older child and adult taking part in regular exercise.

HEALTHY ATHLETES

Children and young adults

The European Society of Cardiology recommend that all children over 12 years old and all adults undertaking competitive sport should undergo sports cardiology screening every 2 years. Competitive sport is defined as any sport that involves competition or regular training.

Please click the following link to read the ESC exercise recommendations paper.

Veteran and Masters Athletes

Increasing numbers of athletes are able to continue their athletic activities into middle and even old age. A Masters or Veteran athlete has a different risk profile to the younger athlete. The main risk is coronary artery disease. This is a condition where the arteries supplying blood to the heart muscle are gradually blocked causing chest pain on exercise or even a heart attack. Coronary artery disease is the most common cause of death in the developed world. Although regular exercise can reduce the risk of coronary artery disease, there are many other important risk factors including a history of cigarette smoking and a family history of heart attacks.

The American Heart Association recommend that all Masters athletes who undertake vigorous exercise should be assessed for risk factors for coronary artery disease ( for example; high blood pressure, diabetes, elevated cholesterol or a history of a heart attack in close relatives under 60 years old). They define a Masters athlete as men over 40 years old and women over 50 years old or after the menopause.

Please click the following link to read the AHA recommendation.

Professional and Elite athletes

Dr Ubaid also provide a screening and assessment service for established club, professional and elite athletes. There is some evidence to suggest that certain cardiac arrhythmias are more common in athletes (for example, atrial fibrillation). Similarly, the process of regular training can occasionally bring out or accentuate a minor underlying cardiac anomaly.

WOULD BE ATHLETES

This service is available for adults taking up exercise for the first time or after a long break in training. The service is designed to exclude major underlying heart problems that may make participation in strenuous exercise hazardous. In older “would-be” athletes (>40yrs), a blood sample will be sent for triglyceride and cholesterol analysis. In combination with physical examination, family history assessment and clinical assessment, this will allow the estimation of approximate future risk of coronary artery disease.

GROUP SCREENING

Amateur Sports Clubs and Schools

Most of the screening and assessment tests can by carried out locally at your Sports Club. Similarly, whole club screening can be arranged. A similar service can be arranged for schools and college teams. Schools screening will be carried out by specialists with experience and accreditation in paediatric cardiology.

Professional Sports Clubs

Dr Ubaid can carry out full sports cardiology screening in accordance with national guidelines. We use protocols for competitive athletes as recommended by the European Society of Cardiology Sports Cardiology Committee. Our screening incorporates the Football Association cardiology screening policy (2007 modifications). All investigations are carried out under the direction of Dr Ubaid. Immediate results are available.

INVESTIGATIONS

All clients undergo a clinical cardiovascular examination by an experienced cardiologist. This involves checking the blood pressure, listening to heart with a stethoscope and examining the pulse and heart size. In addition, two main screening tests are used. The Pre-participation questionnaire is designed to assess the presence of a familial exercise-associated heart problem. It will also pick up any history of medical problems or symptoms which might point to underlying heart disease. The Electrocardiograph (ECG) is a simple test which assesses heart rhythm, the size of heart chambers and can often diagnose an underlying heart muscle or heart rhythm abnormality.

In competitive athletes, we recommend that an Echocardiogram is carried out. This is a detailed assessment of the structure and function of the heart using ultrasound. This allows the precise measurement of heart chamber size, assessment of heart valves and adjacent blood vessels. The echocardiogram is an integral part of the Football Association examination for junior professional footballers.

In older “masters” or veteran athletes (>40yrs), an exercise stress test may be recommended. This involves running on a treadmill while attached to an ECG machine. This test is designed to help assess the underlying risk of coronary artery disease.

ATHLETES WITH SYMPTOMS

A formal sports cardiology assessment is recommended for all athletes suffering from breathlessness, palpitations, chest pain or dizziness/fainting during exercise. In many cases these symptoms will not be due to underlying heart disease.

ATHLETES WITH HEART DISEASE

Regular, carefully prescribed exercise has been shown to have many benefits in patients with heart disease including cardiomyopathy and heart failure. This can improve general physical fitness as well as improving self esteem. For obvious reasons, the approach to regular exercise has to be modified in this group and exercise prescribed in collaboration with the patient’s medical team.  Dr Ubaid provides an exercise prescription service for this patient group provided approval has been given by the patient’s cardiologist.