Is there such a thing as too much exercise? It’s a question a University of B.C. grad student is exploring with the assistance of renowned sports doctors Jack Taunton and Saul Isserow.
Taunton, a former Richmond resident, is supervising the study by Barb Morrison, research and project coordinator at the new Sports Cardiology BC Clinic which Taunton and Isserow co-founded. The goal—through an extensive cardiac questionnaire—is to study 2,000 high-performance and recreational masters-aged (40 and over) athletes to determine if there are any abnormalities that can predict the risk for sudden death.
Certainly no one is questioning the many benefits of physical activity. But there are dangers, including a small increased risk of a heart attack during robust exercise. The aim of the Sport Cardiology Clinic of BC is to assist athletes to stay active while also ensuring their continued safety by being aware of the risks.
One of the founding fathers of sport medicine in Canada, Taunton was himself a keen competitive athlete who participated in more than 60 marathons. But as a masters athlete, he unexpectedly required quadruple bypass surgery following a heart attack in 2000. He has since seen many of those he trained with, including some top-level athletes, suddenly face similar needs. They only served to raise his curiosity as to why.
“Although I had a family history, they didn’t have any apparent risk factor,” Taunton said. “Their weight was low or there was no indication of high blood pressure. So we began to wonder whether exercise could be a factor.”
In the past few weeks, since receiving ethical approval for the study, more than 40 elite, national, international and Olympic-level athletes have been consulted. All of them had very real cardiac concerns, with two elite athletes showing a “malignant” course of an aberrant coronary artery, said Isserow, who as well as being a director at the Sport Cardiology BC Clinic is the medical director at the Vancouver General Hospital Centre for Cardiovascular Health.
“All of this re-emphasizes how important and timely our quest to continue to develop Sport Cardiology BC is,” added Isserow, who himself has a renowned background as a marathon runner.
“Our clinical impression agrees with the apparent increased incidence in atrial fib, and my concern about a number of my patients that are, or were elite endurance athletes having premature coronary artery disease requiring bypass surgery like myself,” Taunton said.
The screening of masters athletes comes on the heels of an extensive similar study of young athletes. Some 800 elite junior athletes under the age of 35 were evaluated in the initial study. Taunton said among those studied in both groups are many runners and triathletes. Among masters-aged athletes, they have shown a higher risk of sudden death. Oldtimers hockey players also appear to be at a high risk, he said, along with weekend warriors with a family history.
Taunton said periods of inactivity followed by high anaerobic exercise along with a past history of smoking, hypertension and high lipids also appear to heighten the risks. He said the high number of tragic deaths during one season a few years ago, in an Ottawa oldtimers’ hockey league, triggered a move to ensure defibrillators are available in every ice rink in Canada. He added defibrillators should be standard equipment at every major triathlon, not to mention other sports venues, as well.
Taunton said one theory being reviewed is the harder an athlete works, the more oxygen they use. One of the end products is that it can lead to damage of the coronary arteries. He said a recent European study concluded that 23 per cent of endurance athletes compared to 12.5 per cent of non-athletes experienced atrial fibrillation (irregular heartbeat). Also known as arrhythmia, atrial fibrillation affects about 350,000 Canadians and generally the risk of developing it increases with age and other risk factors such as diabetes, high blood pressure and underlying heart disease.
“It’s still rare among endurance athletes, but we are seeing more cases of it,” said Taunton.
By looking for risk factors, the detailed studies now being carried out at Sport Cardiology BC may help save athlete’s lives. And that’s the goal, says Taunton.
“Electrocardiograms for instance help us look for signs of underlying heart disease. If we see that, then we do a stress test on the heart,” he said. “What we want to be is two steps ahead. Before someone actually experiences a cardiac event, we want to be able to identify the potential of that happening much earlier.”
Such an extensive study has never been done before in Canada, or for that matter in much of the world. An extensive study by cardiologists of athletes in Italy, however, found a much higher degree or risk factors and episodes of sudden deaths than anyone had seen before, Taunton said. Their findings led to a decree that everyone who wants to participate in sport in Italy must first complete a questionnaire and have an electrocardiogram. The same applies to any athlete from outside the country participating in a competition in Italy, he said.
“The International Olympic Committee is now looking at this, and it’s a topic that has headlined every sports medicine conference in the last six months,” said Taunton.
“And based on what we’ve seen from our study so far, and what we’re going to be seeing, Canada should follow the Italian policy.”
Taunton said it’s even more pressing to implement such guidelines today because of the number of weekend warriors that have boosted participation in sport over the last 10 to 20 years. He said these individuals need to be aware of the potential risks, particularly those that may be unique to themselves, before they venture into the arena of field of play.
“For young athletes, particularly in the competitive stream, the risks are low but if they have any congenital defects they could have symptoms of fainting or shortness of breath and never think anything of it and tragically collapse,” said Taunton.
“And for those older athletes, with so many people reaching 40 and concluding they had better get into a fitness program, the recommendation is to see their physician and have a cardiac questionnaire done along with an exercise stress test.”
Sport Cardiology BC is planning a screening day this Thursday, April 23 from 6 to 9 p.m. Those interested can sign up at sportcardiologybc.org.
For the original article: Richmond Review