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Raju Srivastava death: Is working too hard in the gym harming your heart? Why is the TMT Test Not Enough?

Comedian Raju Srivastava’s death last month after suffering heart failure and collapsing on a treadmill raises an important question: Should we limit our exercise regimen, and are we taking the fitness mantra to extremes and over-extending ourselves. working hard? Is our obsession with being skinny taking a toll on the heart? Cardiologists say that 150 minutes of any exercise per week is good enough and a routine longer than that does not guarantee additional benefits. In fact, it can do more harm than good if the person is already suffering from heart disease and is suffering from markers like high blood pressure, anxiety or even a silent blockage that hasn’t harmed him so far.

“You only need to exercise for 150 minutes five days a week, or 30 minutes each day. It’s going to be a healthy mix of aerobics, weight training (this strengthens muscles, including the heart), and stretching (yoga and breathing exercises). This rotational regime is good for both physical and mental health. Stop during exercise if you feel discomfort and get yourself tested before adopting any high-intensity regimes,” says Dr. Ruchit Shah, Interventional Cardiologist, Masina Hospital, recommend. Mumbai,

“Regular exercise elevates your heart rate, improves your heart muscle and helps increase your lung capacity. On the other hand, there is a phenomenon known as over-exercise. Continuous over-exercise. has been linked to an increased risk of ‘atrial fibrillation’, a form of irregular heart rhythm that can be fatal if left untreated. In addition, it can potentially increase the risk of cardiac abnormalities, especially For people with hypertrophic cardiomyopathy or coronary heart disease,” says Dr Shalin Thakor, Senior Interventional Cardiologist, Shelby Hospitals. Ahmedabad,

What is hypertrophic obstructive cardiomyopathy?

Hypertrophic cardiomyopathy, usually caused by genes, occurs when the walls of the heart chamber (left ventricle) become thicker than normal. The thick walls can harden and this can reduce the amount of blood pumped into and out of the body with each heartbeat. The thickened part of the heart muscle, usually the wall (septum) between the two lower chambers (ventricles), blocks or reduces the flow of blood from the left ventricle to the aorta.

“It can provoke sudden cardiac arrest and a patient needs resuscitation in the first 60 seconds. In fact, we should be training students in schools and colleges about CPR. We all should know how to administer it. Besides, every public place should have defibrillators, school and college students,” says Dr Shah.

Pre-Gym Must-Dos: Not Just a TMT Test

Dr RR Kasliwal, President, Clinical and Preventive Cardiology at Medanta Hospital, Gurgaon advocates a complete cardiac work-up for anyone who goes to the gym or does any strenuous activity. “Just a TMT (treadmill test) doesn’t cut it. These days there is CT angiography which can tell if there is 40 to 50 percent blockage or not. This type of blockage will not be visible on TMT as there is not much reduction in the patient’s capacity. Always know your heart before doing any strenuous activity. Many people who have cardiac arrest don’t live to tell the story.”

He said this should apply to all those who stopped working during the pandemic and are now resuming an old routine. He said such screening is especially necessary for diabetics and women, as they may not experience a heart attack as a normal pain in the chest.

Dr Kasliwal said that COVID-19 The condition of the patient is also very important. “If you have had COVID-19 – and we now know that over a long period of time COVID-19 is causing sudden cardiac death – it is very important that you check your heart health. People who have had COVID – 19, they also sometimes have a high heart rate (tachycardia).”

Intensity and duration act as important factors
“When the treadmill is performed at a very high speed and/or incline, there is a dual effect, that is, heart rate and blood pressure, which are a determinant of the oxygen demand in the heart. metabolic equivalents) can cause undue stress on compromised cardiac circulation in the event of heart blockages. They cause sudden arrhythmias, unreasonably low blood pressure or heart attack. Such people need to be evaluated immediately with coronary angiography. There is a need and there should be proper revitalization, for example, stenting procedure as per the current guidelines,” says Dr Suman Bhandari, visiting consultant, interventional cardiology, Fortis Escorts Heart Institute.

Vigorous activity leaves you breathless and causes heavy sweating. Instead go for moderate-intensity workouts, which include activities that raise your heart rate, such as casual sports, brisk walking, jogging, bicycling and swimming. “Everyone should engage in 30 minutes of moderate-intensity physical activity on a daily basis to reap the health benefits. Refrain from testing your physical strength and physique. Whether you’re a novice or an experienced exerciser, you need to overdo it. Also, give your body enough time to recover and recover. Consult a doctor if you experience any difficulty,” says Dr. Thakor.

How to stop overwork?

Exercise has beneficial effects on the heart, both directly and indirectly. Direct effects include making the heart muscle stronger and pumping more blood per heartbeat, as well as its ability to better cope with abnormal heart rhythms. Indirect effects include beneficial effects on blood pressure, sugar, cholesterol and body fat, all of which reduce the likelihood of a heart attack.

“It is important to note that sudden cardiac death is very rare in a person with a healthy heart. Exercise can be a trigger for a cardiovascular event in individuals who have known or silent heart disease. In the context of a single episode of exercise, No absolute upper limit is defined, and it all depends on the individual’s training level. One should avoid high levels of involuntary exertion, the general rule being that any given exercise exceeds previous bouts by ten percent. There should be no overgrowth. Environmental conditions should also be considered, and outdoor exercise in extreme weather conditions should be avoided; as this is a scenario where even a healthy person can face dire consequences,” Dr. Ashish Contractor, Director, Sports Medicine and Rehabilitation, Sir HN Reliance Foundation Hospital, Mumbai.

He adds that “another way of looking at ‘too much exercise’ is the total amount of exercise accumulated over the years. Here, research has shown that very high amounts of exercise over several decades cause some changes in the heart muscle.” At this point, the amount of exercise is not defined, and the consequences of these changes are not fully understood. However, it is well known that To get optimal health benefits, moderate exercise is the way to go. So how does one reduce the risk? In my opinion, the risk can be reduced by taking care of the following:
1. Pre-Participation Health Checkup
2. Pay attention to the warning signs
3. Wise and suitable training program.

Balancing a fitness routine with a healthy diet

Indians are genetically prone to develop heart disease 15 or 20 years earlier than their Western and Japanese counterparts. And since our genes are not modified, we have to look at modifiable factors such as lifestyle, sleep cycles and stress. “Now the tension has increased with tobacco, tobacco products and alcohol. Do you know that the effect of a single tobacco use lasts for three to six months. Roughly speaking, one cigarette shortens your life by five to seven minutes. This means that a moderate smoker can easily shorten his life by three to five years. Instead of a ‘no smoking’ banner, we should launch a ‘why should you not start smoking’ campaign,” says Dr Shah.

Maintaining physical and mental health requires a good diet and regular exercise. “When people do high-intensity workouts and consume less, the body uses up nutritional stores, leading to depletion. Following fad diets to lose weight can lead to starvation, anemia, heart disease, stroke, Promotes poor mental health etc. Align your diet with your workout regimen. Choose healthy carbs as they provide strength to one’s brain and body. Post-workout carbohydrates recharge the body. Quality post-workout Eating protein rich in fiber repairs muscle microtears and increases blood flow. Some fats are actually healthy despite being rich in calories. Polyunsaturated fat is beneficial. Any sunflower oil, soybean oil, and various nuts and search for seeds
Because they contain omega fatty acids. Finally, the benefits of exercise should not be called in doubt; On the contrary, they should be strengthened. However, moderate activity and a healthy diet are strongly affirmed for a healthy heart,” says Dr Thakor.

Dr Shah advocates the campaign “One glow less (one teaspoon less)”, which involves reducing the use of three whites – salt and sugar and oil in our diet. More fruits and vegetables. Minimize cake and junk food.”

When should you get tested for cardiac fitness?

Coronary artery disease (CAD) can start as early as your teens. Plaque can build up quickly. “To prevent further progression, your first BP, sugar test and lipid profile test should be done at age 18 and then once every three to four years. Be sure to check your BP during every clinical visit. ECG needs to be done once a year when you turn 40 and based on your other parameters, reduce the frequency as advised by your doctor. Watch your LDL levels and those that have not intervened Maintain the level at less than 60 mg/dL for them and less than 30 mg/dL for those with cardiac interventions like stenting,” advises Dr. Shah. No test is foolproof. We need a good vigil. level is required.

Understanding plaque breakdown

Describing these sudden developments, Prof. Srinath Reddy, a cardiologist, epidemiologist and president of the Public Health Foundation of India (PHFI), says, “Chronic blockage of 70 percent or more in coronary artery causes angina or chest pain. Since the available blood supply does not meet the increased oxygen demand of the exercising body and the stressed heart. However, a heart attack (acute myocardial infarction) can occur when soft plaques that form in the coronary arteries rupture and form a large clot. It can come on without any prior warning symptoms. Even 30 percent of plaques can rupture and form a large obstructive clot.”

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