Heart Attack While Running! A Silent Danger That Can Be Prevented by Heart Health Screening Before Running

Exercise is considered a good health practice. However, if you are a beginner runner or a professional runner looking to level up your running or exercise intensity, cardiovascular pre-participation screening is important to detect the risk of heart disease and prevent sudden death during exercise.

Being physically fit… does not mean you are free from heart disease risk

Statistics show that sudden death occurs in healthy long-distance runners at a rate of about 1 in 15,000 to 1 in 150,000 per year. Simply put, if there are about 200,000 runners competing in a year, there will be approximately 1-2 cases of sudden death.

Who is considered at risk?

• Those diagnosed by a doctor with coronary artery disease, ischemic heart disease, or previous myocardial infarction
• Those diagnosed with cardiomyopathy, pericardial disease, congenital heart disease, heart failure, or cardiovascular disease combined with ischemic heart disease, severe arrhythmias, or abnormal heart function
• Those experiencing symptoms consistent with cardiovascular disease such as chest tightness, chest pain, jaw pain, easy fatigue, shortness of breath when sitting, lying down, exercising, lifting heavy objects, feeling angry or excited; shortness of breath at night causing awakening; palpitations, irregular heartbeat; dizziness, fainting, or loss of consciousness especially during exercise or when changing positions
• Those with cardiovascular risk factors such as a family history of direct relatives (men under 55 years old, women under 65 years old) who have suffered or died from cardiovascular disease, smoking behavior, diabetes, hypertension, abnormal cholesterol, or arrhythmias
• Those who are unsure or suspect they might be at risk

What does cardiovascular pre-participation screening include?

1. History taking, such as exercise consistency, desired exercise intensity, symptoms related to heart disease like dizziness, fainting, chest tightness, palpitations, heart disease risk factors, and family history
2. Physical examination, especially of the cardiovascular system
3. Standard assessments such as PAR-Q+
4. Additional tests to identify heart disease risk factors, such as blood lipid levels and electrocardiogram (ECG)
5. Other additional tests when indicated, such as exercise stress test, echocardiogram, cardiac imaging

Regardless, running for exercise remains a beneficial behavior for overall health. However, runners are advised to self-assess, not ignore warning signs, avoid overexertion, and if experiencing abnormal symptoms, promptly seek evaluation by a specialist.

Sources:

1. Recommendations for athletes or beginners to prevent sudden death from sports, Heart Prevention and Rehabilitation Club, Thai Cardiovascular Society
2. Lluıs Mont, et al. Pre-participation cardiovascular evaluation for athletic participants to prevent sudden death: Position paper from the EHRA and the EACPR, branches of the ESC. Endorsed by APHRS, HRS, and SOLAECE. Europace (2017)19, 139–163
3. Riebe, Deborah, et al. Updating ACSM’s Recommendations for Exercise Preparticipation Health Screening, Medicine & Science in Sports & Exercise: (Nov2015)47, 2473-2479