Raju Srivastava’s death: Is stress in the gym bad for your heart? Why is the TMT test not enough?

The death of comedian Raju Srivastava, after suffering a heart attack and collapsing on the treadmill last month, raises a major question: Should we have a limit to our exercise regimen, are we casting the fitness mantra to the extreme and over-exerting ourselves? Does our obsession with shyness put pressure on the heart? Cardiologists say that 150 minutes of any exercise regimen each week is good enough and a routine longer than that does not guarantee additional benefits. In fact, it may do more harm than good if the person is already prone to heart disease and suffers from signs such as high blood pressure, anxiety, or even a silent blockage that has not harmed them yet.

“All you need is 150 minutes five days a week, or 30 minutes of exercise every day. It should be a healthy combination of aerobic exercise, weight training (this strengthens the muscles, including the core) and stretching (yoga and breathing exercises). This alternation is beneficial for both physical and mental health. Stop during exercise if you feel uncomfortable and do a test for yourself before adopting any high intensity regimen,” advises Dr. Rushit Shah, Interventional Cardiologist, Masina Hospital, Mumbai.

“Regular exercise increases the heart rate, improves heart muscles and helps boost lung capacity. On the other hand, there is a phenomenon known as overexertion. Constant excessive exertion has been linked to an increased risk of developing ‘atrial fibrillation’, a form of Arrhythmia can be fatal if left untreated. Besides, it can increase the risk of heart abnormalities, particularly for those with hypertrophic cardiomyopathy or coronary heart disease,” says Dr. Shalin Thakur, Senior Interventional Cardiologist, Shalby Hospitals Ahmedabad.

What is hypertrophic obstructive cardiomyopathy?

Hypertrophic cardiomyopathy, usually caused by genes, occurs when the walls of the heart’s chamber (left ventricle) become thicker than normal. The thickened walls may become stiff and this can reduce the amount of blood that is absorbed and pumped to the body with each heartbeat. The thickened portion of the heart muscle, usually the wall (septum) between the two lower chambers (ventricles), blocks or reduces blood flow from the left ventricle to the aorta.

This can lead to sudden cardiac arrest and the patient needs resuscitation within the first 60 seconds. In fact, we should train students in schools and colleges in CPR. All of us should know how to manage this. Besides, every public place should have defibrillators, schools and college students.

A Must-Do Pre-Gym: Not Just a TMT

Dr. RR Kasliwal, Head of Clinical and Preventive Cardiology at Medanta Hospital, Gurgaon, advocates for a complete heart scan for anyone who goes to the gym or does any strenuous activity. “Just a TMT (treadmill test) does not do the job. These days there is a CT angiography that can tell if there is a blockage in 40 to 50 percent. Such a blockage will not show up on TMT because there is no significant impairment in the Patient ability. Always know your heart before doing some strenuous activity. Many people who go into cardiac arrest don’t live to tell the tale.”

The same should apply to anyone who stopped exercising during the pandemic and is now resuming an old routine, he said. Such checks are especially necessary for diabetics and women, he said, because they may not experience a heart attack as typical chest pain.

Dr. Kasliwal said that COVID-19 The position of the patient is also very important. “If you have had Covid-19 – and we now know that prolonged Covid-19 leads to sudden cardiac death – it is very important that you check the health of your heart. Those who have had Covid-19 also have a high heart rate (tachycardia). ) Sometimes “.

Intensity and duration act as critical factors
“When the treadmill is run at a very high speed and/or incline, there is a dual effect, which is heart rate and blood pressure, which is one of the determinants of the heart’s need for oxygen. High measurements (metabolic equivalent) during high speed and for long periods can cause stress Unnecessarily on the circulatory system of a compromised heart in the event of a heart block.Cause sudden arrhythmia, unexplained hypotension or heart attack.Dr Suman Bhandari, Visiting Consultant, Interventional Cardiology, Fortis Escorts Heart Institute, says, “Those need People need urgent evaluation with coronary angiography and should have appropriate revascularization, eg, stenting according to current guidelines.”

Vigorous activity makes you breathe and sweat heavily. Go for moderate intensity exercises instead, which include activities that increase your heart rate, such as casual sports, brisk walking, jogging, biking, and swimming. “Every individual should do 30 minutes of moderate intensity physical activity on a daily basis in order to reap the health benefits. One should avoid testing their physical strength and fitness. Whether you are a beginner or an experienced exerciser, you should not overdo it. In addition, Give your body enough time to recover and recover. Consult a doctor if you face any difficulties,” adds Dr. Thakur.

How to prevent excessive stress?

Exercise has direct and indirect beneficial effects on the heart. Direct effects include, helping the heart muscles get stronger and pumping more blood per heartbeat as well as being able to better tolerate abnormal heart rhythms. Indirect effects include beneficial effects on blood pressure, sugar, cholesterol, and body fat, all of which reduce the chances of a heart attack.

“It is important to keep in mind that sudden cardiac death very rarely occurs in someone with a healthy heart. Exercise may be the trigger for a cardiac event in individuals with undetected or silent heart disease. For a single episode of exercise, there is no upper limit. Specific, and it all depends on the level of training of the individual.One should avoid unusually high levels of exertion, the rule of thumb is that any bout of exercise should be no more than 10 percent compared to previous bouts.Environmental conditions should also be taken into account, avoiding exercise Outdoors in extreme weather; Dr Ashish Contractor, Director of Sports Medicine and Rehabilitation, Sir HN Reliance Foundation Hospital in Mumbai, says this is one of the scenarios in which a healthy person could suffer dire consequences.

He adds, “Another way to look at ‘too much exercise’ is the total volume of exercise that has accumulated over the years. Here, research has shown that too much volume of exercise over several decades may cause some changes in the heart muscle, as well as a buildup of calcium in the arteries.” Coronary At this point, the amount of exercise has not been established, and the consequences of these changes are not fully understood.However, it is known that moderate exercise is the way to reap the optimal health benefits.How does one reduce risk?In my opinion, risks can be reduced through Pay attention to:
1. Health check before participation
2. Pay attention to warning signs
3. Reasonable and appropriate training programmes.

Balance a fitness routine with a healthy diet

Indians are genetically susceptible to heart disease 15 or 20 years earlier than their Western and Japanese counterparts. Since our genes are not modifiable, we have to look at modifiable factors such as lifestyle, sleep cycles, and stress. Now the tension is exacerbated by tobacco, tobacco-derived products and alcohol. Did you know that the effect of even one-time tobacco use lasts for three to six months? By rough estimates, a cigarette shortens your life by five to seven minutes. Which means that a moderate smoker can easily cut his life from three to five years. Instead of ‘No Smoking’ banners, says Dr. Shah, we should start the ‘Why you shouldn’t start smoking’ campaign.

Maintaining physical and mental health requires a good diet and regular exercise. “When people do high-intensity exercise and consume less, the body uses up nutritional reserves, causing a deficit. Banal diets to lose weight promote hunger, anemia, heart disease, stroke, poor mental health, etc. Align Your diet with your exercise regimen Choose healthy carbohydrates because they give your brain and body energy Carbs recharge your body after exercise Eating high-quality proteins after exercise repairs micro-teasers in muscles and boosts blood flow Some fats are actually healthy despite being calorie-dense Thermal polyunsaturated fats are beneficial.One can also look for sunflower oil, soybean oil and various nuts and seeds
It contains omega fatty acids. In conclusion, the benefits of exercise should not be questioned; On the contrary, it must be strengthened. However, moderate activity and a healthy diet are highly emphatic for a healthy heart,” says Dr. Thakur.

Dr. Shah endorses the “ek chamach kam (one teaspoon less)” campaign, which involves reducing our use of the three eggs in our food – salt, sugar and oil. More fruits and vegetables. Cut back on cakes and junk foods.”

When should you undergo a cardiac fitness test?

Coronary artery disease can begin in the teenage years. Plaque can form early. “To prevent further buildup, you should have your first blood pressure test, sugar test, and lipid profile test at age 18 and then once every three to four years. Check your blood pressure during each clinical visit. You need to have an EKG once a year when you are 40 years old. Depending on your other criteria, space the frequency as advised by your doctor.Monitor your LDL levels and for those who have not undergone the intervention, keep the level at less than 60mg/dL and for those undergoing cardiac intervention such as stenting, below 30mg/dL Dr. Shah advises. There is no guaranteed test. What we need is a good level of alertness.

Understanding plaque rupture

Explaining these sudden episodes, Srinath Reddy, a cardiologist, epidemiologist and chairperson of the Public Health Corporation of India (PHFI), says: “Chronic blockage of 70 percent or more in a coronary artery leads to angina or chest pain on exertion, because the supply of Available blood does not meet the increased oxygen demand of the body that exercises and stresses the heart.However, a heart attack (acute myocardial infarction) can occur when the soft plaques that form in the coronary arteries rupture and cause a large clot to form.This may come without No prior warning symptoms.Even 30 percent of plaques can rupture and form a large occlusive clot.

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