LONDON - Heart disease can mark the end of a journey or even threaten the lives of both competitive and recreational athletes, but doctors know that in many cases, heart problems can be treated to help patients exercise. Elijah Behr, MD , a cardiologist at Mayo Clinic Healthcare in London, explains the general trend of keeping athletes with heart problems on their journey and games.

Dr. Behr said significant research has evaluated the actual risk of cardiac arrest in young athletes with heart disease. They include discoveries in the Mayo Clinic about long QT syndrome , a heart rhythm disorder that can cause a fast, irregular heartbeat.

“There is a general tendency to allow more exercise for well-treated patients,” says Dr. Behr. “This is supposed to be a customized approach that addresses the patient in a holistic manner using the expertise of a specialist, and their gym, school or college may be involved in ensuring the safest way forward. ".

A device that can help athletes return to play after a cardiac arrest is an implantable cardioverter-defibrillator . Dr. Behr shows that electronic readings can be taken from the heart and determine if there is a life-threatening heart rhythm problem , then an electrical shock is delivered to restore the heart rhythm to normal. In general, the devices are very effective at saving lives when the heart stops, he says.

Cardiac arrest is often caused by an underlying heart condition that may scar the heart, leaving it vulnerable to a rhythm problem that causes the heart to stop, says Dr. Behr.

"It is unusual for cardiac arrest itself to cause any more damage to the heart than underlying heart conditions. There are also some conditions that are primarily electrical and are not associated with any damage to the heart muscle itself" - says Dr. Behr. "It is possible for the athlete, if there is little or no damage to the heart, to return to normal work and performance. It depends a lot on the condition and its severity."

Dr. Behr adds: “Research on sudden death in young athletes and non-athletes indicates that the frequency of sudden death may be more than double in athletes; this is thought to be due to the effect of extreme exertion in people with underlying heart conditions such as cardiomyopathy . " He adds that this is still rare, noting that most sudden cardiac deaths do not occur during exercise.

In general, Dr. Behr says, older athletes who've done endurance or high-intensity exercise for many years tend to have more heart rhythm problems and coronary artery problems than their non-athletes age counterparts.

“We think this may be the result of excessive stress on the heart from intermittent periods of high blood pressure and high heart rate. This is still not fully understood and more research is needed,” says Dr. Behr. "There is a significant benefit in general from exercise in quality of life and longevity, which may outweigh any other risks of heart problems."

If exercise aggravates the heart condition or even increases the risk of cardiac arrest, cardiologists can work with athletes to reduce the intensity and length of the activity, says Dr. Behr. To reduce the intensity of exercise, medications and heart rate monitors may be used to lower the heart rate.

These restrictions may be too much for competitive athletes, and may require them to change sports if they wish to continue competing. Moving from more challenging and dynamic sports to less challenging may be the only way to balance patients' psychological needs with the risks of their health conditions, he says.

“In general, exercise is a good thing and its practice is good for the mind and body. We must avoid unduly restricting patients, but rather strike the right balance for them,” explains Dr. Behr. "They are more likely to comply with their treatment plans and do well in general."

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