Dr. Oller Cid is a renowned specialist in Cardiology, with a long career in the prevention and treatment of valvular and coronary diseases, among other pathologies of the cardiovascular system. In the following article she explains the problems related to sport and the heart.
Adequate heart rate threshold for sporting activities
Although there are individual variations, the maximum exercise frequency is calculated with the formula of 220 minus the age of the individual, i.e., with age there is a lower acceleration of the heart rate during exercise. This is the maximum point rate at which the heart can reach while maintaining its normal rhythm, and it is advisable not to exceed 85-90% of this figure for periods longer than 5 minutes during exercise.
Aerobic exercise is the one that obtains energy by burning fat, through its oxidation, that is to say, it needs oxygen; this type of exercises are walking, running, swimming and cycling. Anaerobic exercise obtains energy by burning fat deposits directly in the muscle, without prior oxidation; this type of exercise is mainly weight training such as weight lifting, sit-ups, certain gymnastic apparatus, or when exceeding 85-90% of the maximum heart rate, which is the point where the anaerobic threshold is statistically found.
Aerobic exercise, from a certain point, also begins to obtain energy directly from the muscle and metabolism changes from aerobic to anaerobic, this is known as anaerobic threshold and is usually around 85-90% of the maximum heart rate to which we referred at the beginning.in people who do very intense physical exercise and want to know exactly their anaerobic threshold, you can perform a stress test with oxygen consumption, which accurately establishes the threshold. Although usually the information of staying above 85-90% of the figure obtained from 220 minus age, is sufficient.
What kind of sport can be done if there are heart problems?
The majority of heart diseases, when they are in a stable situation, allow the patient to continue doing sports normally, recommending above all aerobic exercises and adapting the advisable heart rate threshold according to the type of disease and the treatment received by the patient.
However, there are some diseases that require absolute rest for a few weeks, as in the case of pericarditis, which is an inflammatory disease of the heart, and others that do not require any limitation, such as arrhythmias in healthy hearts and mild valvular disease. When arrhythmias or heart growth are detected in relation to sport, it is not advisable to abandon the sport, although it is recommended that the intensity of the sport be reduced. As a general rule, only in some special situations is the total elimination of sport recommended and, on the contrary, aerobic exercise in sessions of 45 minutes 4 or 5 days a week is recommended for most patients.
What to do when feeling pricks in the chest while doing sport?
When the heart musculature senses a reduction in the amount of blood it receives, it responds with the appearance of chest pain, but it rarely manifests itself in the form of pins and needles. The pain to be alerted is of an oppressive or burning character, usually in the center of the chest and radiating to the shoulders, arms, back or jaws. In this situation, you should immediately stop exercising and call for help. Prickling pain, especially if it varies with breathing, is not of cardiac origin, but of the thoracic musculature. On this occasion, it is sufficient to reduce the degree of exercise or to stop for a few minutes and then resume at a lower intensity.
Relationship between sport and sudden death
Fortunately it is very rare, although it has a great impact when it occurs suddenly and in apparently healthy people. Under 35 years of age it is generally due to diseases of the heart musculature that have not been previously detected, and on rarer occasions, to congenital diseases affecting the valves or the origin of the coronary arteries. Above the age of 35, most cases are due to diseases of the heart arteries, which are narrowed by the appearance of arteriosclerosis and which, on some occasions, have not given symptoms until the presentation of an infarction during exercise.
Sudden deaths during sport unrelated to the heart are rarer; mainly cerebral vascular accidents and, in the case of very intense, sustained and strenuous exercise, alterations in the hydroelectrolyte balance (dehydration and acidification of the blood) that can lead to lethal arrhythmias, even in an anatomically healthy heart.