Cardiac check-up for athletes: when and why

A cardiac check-up for athletes is an assessment of your heart before you start or continue intense sport. Exercise is very good for the heart, but a small number of people have a heart condition that causes no signs in everyday life and only shows up under heavy exertion. A simple check-up can pick up this problem in time.

Why is a heart check before sport important?

Sudden cardiac events in young athletes are rare, but when they happen they are often tragic, because they affect people who seem completely healthy. In young people, the most common causes are congenital or inherited conditions, such as:

• hypertrophic cardiomyopathy – thickening of the heart muscle;
• congenital coronary artery anomalies – when the heart’s arteries have an unusual origin or course;
• arrhythmogenic cardiomyopathy and other heart muscle diseases;
• inherited electrical disorders, such as long QT syndrome or Wolff-Parkinson-White syndrome;
• myocarditis – inflammation of the heart muscle, often after a viral infection.

After the age of 35, the most common cause is coronary artery disease, which often develops without symptoms for years.

Who should have a cardiac check-up?

A cardiac check-up is especially recommended for:

• athletes who compete in organised sport, young or adult;
• people over 35 starting intense exercise after a period of inactivity, such as long-distance running, cycling or hard gym training;
• people with risk factors: high blood pressure, high cholesterol, diabetes, smoking or excess weight;
• anyone who has had symptoms during exertion, such as chest pain, dizziness or fainting;
• people with a relative who died suddenly before the age of 50 or who has an inherited heart condition.

What does the check-up include?

The check-up starts with a cardiology consultation: the doctor asks about your symptoms, your sport and your family history, measures your blood pressure and listens to your heart. Then, as needed:

• ECG – a quick, painless test that can detect many electrical disorders and signs of a thickened heart muscle.
• Echocardiogram – shows the structure of the heart, the thickness of its walls, the valves and how well it pumps.
• Treadmill stress test – shows how your heart responds to exertion, especially useful for people over 35 or with risk factors.

An athlete’s heart adapts to training and may look slightly larger or beat more slowly. The cardiologist can tell this normal adaptation apart from disease. Sometimes extra tests are needed, such as a Holter monitor or a cardiac MRI, which is done in hospital.

A normal result greatly lowers the risk, but does not rule it out completely. That is why the check-up is repeated periodically, as your doctor advises.

Warning signs during sport

Stop exercising and see a doctor if, during or right after exertion, you have:

• pain, tightness or pressure in the chest;
• breathlessness that is unusual for your level of fitness;
• palpitations or an irregular heartbeat;
• dizziness or fainting, especially during exertion;
• unusual tiredness or a sudden drop in performance.

Don’t train hard when you have a fever or a viral infection, as this raises the risk of myocarditis. If someone collapses unconscious during sport, call emergency services on 127 straight away, start chest compressions and use a defibrillator if one is nearby.

Book your cardiac check-up

Book a consultation before starting a new sport, before the competitive season, or if you have had any of the signs above. At Dr. Medical Clinic & Lab, our cardiologists carry out the consultation, ECG, echocardiogram and treadmill stress test in the same clinic and advise you on the level of activity that is safe for you.

Our cardiology clinic in Tirana

This article is for information only and does not replace a consultation with a doctor.