José Ferreira Santos, Cardiologist, Hospital da Luz Setúbal Helder Dores, Cardiologist, Hospital da Luz Lisboa Physical exercise is associated with the prevention of cardiovascular disease and cancer, two of the main causes of death in developed countries. For these reasons, the number of physical exercise practitioners has increased progressively. Who can be considered an athlete? We can consider an athlete any regular exerciser who participates in organized sport events, even recreationally, including children, middle-aged adults and the elderly, besides the usual top-level athletes. If you are over 35, don’t take risks! In people over 35 years old, moderate to high intensity physical exercise may be associated with an increased risk of cardiac events. These events may occur in “healthy” individuals with unidentified and uncontrolled cardiovascular risk factors, or with undiagnosed and asymptomatic heart disease. In individuals with increased risk, inappropriate physical exercise can trigger an acute myocardial infarction or cause sudden death, potentially avoidable complications. Are you going to start exercising? First evaluate the health of your heart. Anyone wishing to start regular exercise and who has at least one of the following warning signs should consult their doctor to make an assessment of their risk: Risk factors: To be over the age of 40; Sedentarism; Overweight or obesity; Smoking; Hypertension; Diabetes; High cholesterol; Family history of sudden death or heart attack in first-degree relatives under 55 years of age. Symptoms: Chest pain Palpitations; Loss of consciousness; Fatigue or shortness of breath aggravated by exertion; History of previous heart disease. What is cardiac risk assessment? The risk assessment should be individualised taking into account: Age; Clinical history; Type and intensity of the physical exercise to be practiced. In a first evaluation, the clinical history and objective examination are usually complemented with: Analysis, including determination of glycaemia and lipid profile; Resting electrocardiogram. After the initial assessment, and in case of doubts about the level of risk, some further examinations may be necessary, for instance: Stress test; Echocardiogram; Calcium Score Coronary artery CT Angiography Cardiovascular evaluation for exercisers In addition to the clinical evaluation prior to the beginning of the sport practice, it’s fundamental that athletes of a recreational or competitive level, in particular veterans, who maintain a regular practice of at least moderate intensity physical exercise, consult their doctor once a year, in order to exclude high risk situations. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
