Exercise and sudden death

Dr Ajit Bhagwat

Every few months we hear a story about some celebrity, doctor or an athlete dying suddenly. While some deaths occur in a gym or during exercise, some of these fitness freaks die suddenly at home. These events cause a transient ripple in the collective mindset of society and the cardiologists get a barrage of phone calls and outpatient patient visits for a few days immediately following the event. Most of these people are anxious and want to know if they should exercise and how much.

It is important to remember that an event occurring during a certain activity doesn’t necessarily prove a causal relationship between the activity and the event. If you die in bed doesn’t mean that the bed killed you! However, if you die while eating, there is a possibility that you choked on a piece of bone. While there couldn’t possibly be any cause-effect relationship between bed and death, there could be such a relationship between food and death. This is called a plausible hypothesis about the potential relationship. People are rightfully worried because there is a plausible relationship between vigorous physical activity and death. The answer to the fear of death by choking on food is not to stop eating but to be mindful while eating. The same is true about exercise.

The benefits of exercise on human health and well-being cannot be over-emphasised. However, caution is to be exercised while embarking on any exercise programme particularly after the age of forty. The type of exercise to be chosen, the speed of escalation of intensity of exercise and the targeted maximum intensity of exercise are all very important and are very individual specific. The factors to be considered are age, body weight, co-morbid conditions like diabetes, general fitness level and previous exposure to exercise. Perhaps the most important question to ask is the reason that has motivated the individual to embark on exercise programme particularly when the individual is over 40 years of age. It is often noticed that people have unrealistic goals of losing a certain pounds of weight before some deadline like a wedding in the family or a job interview. Such individuals are likely to resort to heroic and unphysiological measures resulting in untoward consequences.

Herd mentality, often seen in events like marathon running, is detrimental. Every middle-aged individual should make sure to get a health check up and rule out cardiac problems before embarking upon any intensive fitness and exercise programme. The type and intensity of exercise should be tailored to his profile and it should change with advancing age. It is important to note that even patients with advanced heart diseases are advised to exercise within limits that are set by the doctor with the help of science!

(Director, Cardiac Cath Lab and Interventional Cardiology

Kamalnayan Bajaj Hospital, Aurangabad).