When is a workout too much?

Read a Q&A on exercise and its effects on the heart with Jeff Tyler, MD, a interventional and structural cardiologist at Providence St. Joseph Hospital.

Q. Why is exercise good for the heart?

Exercise is one of the best ways to lower our risk for developing heart disease and to lower the risk for future events in those who have heart disease.

Regular, moderate exercise helps the heart by modifying the risk factors known to cause heart disease. It lowers cholesterol, reduces blood pressure, improves blood sugar and decreases inflammation.

Q. At what point does exercise become too much of a good thing for the heart?

Overall, the benefits of regular exercise far exceed the potential risks.

Recent studies have investigated if extreme, long-term endurance exercises can have a negative effect on the heart. These are not the typical “weekend warriors.” These individuals participate in long or frequent, high intensity activities such as ultra-marathons of 50 to 100 miles or weekly marathons. In this small minority of exercise participants, we see evidence of heart remodeling that may be harmful or rises in cardiac enzymes that may suggest heart injury. However, for the vast majority of Americans, these concerns about extreme exercise do not apply and the benefits of regular exercise far outweigh these small risks.

  1. What signs or symptoms indicate I should stop working out immediately?

Before starting an exercise routine, I educate each of my patients about the importance of listening to his or her body. Chest pressure or pain, palpitations, extraordinary shortness of breath, dizziness or a drop in exercise capacity for those already exercising should be seen as warning signs. If a new or seasoned exerciser feels these symptoms, they should stop exercising immediately and seek out medical evaluation before returning to exercise.

  1. Why should I pay attention to these signs?

These signs may herald a potentially life-threatening heart condition such as a heart attack, valvular heart disease or heart arrhythmia, which is abnormal electrical conduction between our heart’s chambers. Identified early, these conditions are treatable, and people can resume exercising thereafter. However, left unchecked, they can lead to irreversible heart injury, heart failure or even death.

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