Cardiac maladaptations to heavy exercise – Cardiology MCQ – Answer

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Cardiac maladaptations to heavy exercise – Cardiology MCQ – Answer

Potential cardiac maladaptations to high volume vigorous exercise: d) All of the above

Although moderate intensity exercise has long term beneficial cardiovascular effects, high volume vigorous exercise may have some potential adverse effects as recognized by recent studies. Moreover, vigorous physical activity by unfit individuals may precipitate sudden cardiac death and acute myocardial infarction in susceptible individuals. But this should not discourage regular tailored exercise programs which have long term beneficial effects.

Prolonged exercise increases cardiac biomarkers and post exercise transient myocardial dysfunction. Endurance athletes above the age of 35 years have increased myocardial late gadolinium enhancement  (LGE) indicating myocardial fibrosis. They also have elevated coronary artery calcium scores and higher incidence of atrial fibrillation. High intensity high volume exercise may thus be deleterious in some individuals. This goes with the usual saying that even something which is a panacea could be harmful if too much!

Vigorous exercise is defined as intensity of exercise at 60% or more of functional capacity and moderate intensity as 40-59% of functional capacity.

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Reference: Franklin BA, Thompson PD, Al-Zaiti SS, Albert CM, Hivert MF, Levine BD, Lobelo F, Madan K, Sharrief AZ, Eijsvogels TMH; American Heart Association Physical Activity Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Stroke Council. Exercise-Related Acute Cardiovascular Events and Potential Deleterious Adaptations Following Long-Term Exercise Training: Placing the Risks Into Perspective-An Update: A Scientific Statement From the American Heart Association. Circulation. 2020 Mar 31;141(13):e705-e736.