Fit But Is Your Heart Healthy? What Every Runner and Hyrox Athlete Should Know

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Michelle Martin (0:22)

Marathons sell out in seconds here in Singapore. You may feel perfectly healthy at sign up for those marathons, but do you have a heart that's ready for strenuous activity?

I understand there are lots of gyms that have this test called the VO2 max score that might show strong gym performance or that you're ready for your workout with your private trainer, but it's not the same as a clean bill of heart health. So with me today is a cardiologist from NHG Heart Institute to talk about the difference between how fit you are versus how fit you actually are. Dr. Bharat Vashdev Khialani is consultant cardiologist at the Department of Cardiology at Tan Tock Seng Hospital. Good morning, doctor. How are you?

Bharat Vashdev Khialani (1:06)

Thanks very much, Michelle. I'm good. Thanks for having me here.

Michelle Martin (1:09)

Thanks for being here. So let's start with the apparent contradiction. How can you be fit but have an underlying heart condition?

Bharat Vashdev Khialani (1:15)

Yeah, that's a really good question. So I guess fitness and heart health, they're related, but they're not one and the same thing. You can be physically fit, but depending on your age and other risk factors may have underlying heart issues. So they're different things. They are related and it's important to understand that heart disease is something that's more and more prevalent these days and something to really just be wary of and be aware of, particularly if you're embarking on exercises, like you've mentioned, marathons, hyrox competition, high intensity exercise in particular.

Michelle Martin (1:54)

I was just reading over the weekend, two men in the Great Run Company in North East of England. So this is a famous run. Some over 60,000 people take part in this run annually. And two men collapsed and both died. They were both runners who were 25 years old at the time. So you might feel fit. You might be young and 25 as well, but you could still have an underlying heart condition. So what is sort of conditions that go unnoticed in someone who does exercise regularly and does feel well?

Bharat Vashdev Khialani (2:26)

Yeah, again, you know, that is quite an alarming story to read, but in the big scheme of things, hundreds of thousands of people, if not millions, take part in marathons every year.

And we do hear stories like this of a small proportion of people having events during these marathons. In young patients like these in particular, some of the things that may result in them collapsing and eventually passing away could be inherited conditions, abnormal rhythms of the heart, structural abnormalities of the heart that won't pick up because of their young age and their ability to perform it at higher levels. And undiagnosed coronary artery disease is happening in younger and younger patients these days as well. So these are conditions that may result in such events. They're rare, but they can happen. And so, you know, being careful and being aware of some symptoms and risk factors in particular, especially if you've got a family history of premature cardiac disease or sudden cardiac death, then that's important to take into account and it may be something worthwhile to speak with a medical professional before you embark on such exercise.

Michelle Martin (3:41)

Got one coming in for you, Doc. I don't know what an R-B-B-B condition is. Do you know what that is?

Bharat Vashdev Khialani (3:46)

Yes, I do.

Michelle Martin (3:47)

Okay. If someone with an R-B-B-B condition has that, but no underlying health issues, should that person be concerned and not do long endurance runs?

Bharat Vashdev Khialani (3:58)

Yeah, thanks to the listener for that question. So R-B-B-B or right bundle branch block is a pattern that we see on the ECG.

The ECG is sort of a resting electrical snapshot of the heart, a 10-second sort of snapshot of the heart. And there's various patterns that we do see on the ECG, some of them completely benign and normal. Some of them can suggest some underlying condition with the heart, like a structural condition or electrical condition of the heart. In younger patients, sometimes we do see this right bundle branch block pattern and it can be completely normal.

Michelle Martin (4:35)

What does that mean? There's a block?

Bharat Vashdev Khialani (4:37)

It's just the way the electrical signal conducts down the heart. It goes down one side of the heart a bit faster than the other. And it can be a normal variant.