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According to cardiologist Bruce F. Waller, MD, located at The Indiana Heart Institute at St.Vincent, individuals who are interested in starting a sport or exercise program should begin with a physical exam by a physician. Starting with students in middle and high school, a pre-participation physical is usually required before joining a sport. The goal is to identify anyone with heart disease before they start an exercise program to help ensure safety.
In some cases a treadmill test is used to help evaluate risk factors for heart problems. Dr. Waller notes that individuals 25 to 30 years of age and older who have not exercised regularly for some time and want to get back into a conditioning program should undergo a treadmill test. This helps the physician evaluate risk factors and screen for potential heart problems to ensure a safe exercise program.
Unfortunately, some individuals with congenital heart defects may pass a physical and not know they may be at great risk. For this reason, Dr. Waller recommends a simple two-minute test called an echocardiogram screen, which will pick up any of the four leading causes of sudden death of athletes. The two-minute test is only required once every four years.
In a recent Indianapolis tragedy, basketball player John Stewart of Lawrence Township died during overtime in a playoff game. It was later determined that he had a heart defect from birth, which an echocardiogram would have picked up. This case is helping heighten the awareness locally for such tests. In another case, Dr. Waller reports that a Purdue all star track athlete was recently screened and identified with the same abnormality. She dropped out of the sport, because it put her at great risk.
To make the screen more accessible locally, The Indiana Heart Institute at St.Vincent has begun offering the test on school sites for only $10 each to cover the basic expenses. After studying 3,000 athletes, Dr. Waller said they determined the low-cost tests could be very effective. Starting in the fall of 1998, they started scheduling visits at various schools to offer the tests during evening hours. Students at Washington, Lawrence and Pike schools have had the screens. Dr. Waller reports the program has been well received by schools, parents and athletes, generating as many as 400 students in one evening.
Athletic directors who are interested in having the echocardiogram screenings in their schools should call Terry at 338-6227.
Dr. Waller is also the coeditor of a book on this topic entitled, "Cardiovascular Evaluation of Athletes: Toward Recognizing Young Athletes at Risk of Sudden Death," written by cardiologists Bruce F. Waller, MD, and W. Proctor Harvey, MD. It is available in bookstores or online ($74) through http://www.bn.com/ or http://www.amazon.com/.
Preventing heart disease
To help prevent heart disease and for long-term good health, Dr. Waller recommends exercising a minimum of three times a week for at least half an hour. You don't need to go to the extreme of being a marathon runner, regular exercise on a consistent basis is just as helpful, he adds.
A well-balanced diet that is low in fat and salt and includes a variety of fruits and vegetables is also recommended. For heart disease prevention, there is good data to support the use of antioxidants and vitamin E, which show a wide range of benefits for preventing cardiovascular disease and other health problems.
Recognize signs and symptoms of heart disease Active individuals should always be on the lookout for signs or symptoms of a heart problem.
Don't Ignore these Three Symptoms:
- Chest Discomfort - Whether you are a beginner or a trained athlete, always pay attention to chest discomfort, says Dr. Waller. Don't write it off; pay attention and have it checked out by a trainer or physician within a day or two at most.
- Shortness of Breath - If you have been exercising regularly and suddenly feel very short of breath, or if you have just started exercising, but feel very week and out of breath, you should be checked out by a physician promptly. It may be a major sign of heart trouble.
- Dizziness, Blackouts - These may be attributed to dehydration or excessive workouts, but definitely need to be evaluated. Blackouts should be assessed immediately by a qualified physician or cardiologist.
Managing your Heart Problems when you Play Sports
If a problem has been identified with your heart, precautions may be needed regarding exercise. These will depend on your particular type of heart disease. Some heart defects do permit exercise in varying amounts. Some athletes with heart defects can even remain competitive in their sport. By no means do all congenital heart problems lead to a sedentary lifestyle, says Dr. Waller. However, the particular situation needs to be evaluated by your cardiologist, and some cases may require eliminating competitive exercise to prevent tragedies. You should discuss any limitations and precautions with your cardiologist before resuming play. With other types of heart disease, exercise may be encouraged.
Treating and Managing Heart Disease
If you have been diagnosed with heart disease, your cardiologist will discuss your medical or surgical treatment options, as well as lifestyle adjustments that may be required. Your activity level may affect your treatment plan. Ask your doctor about proper diet, recommended exercise levels, supplements or medicines that should be part of your treatment plan.
Generally, those with heart disease should focus their diets on low salt intake, low fat intake, and a well-rounded diet. Talk to a dietician or your cardiologist for details. You may also wish to consult one of many heart healthy cookbooks available for guidelines, such as one distributed by the American Heart Association.
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