What should your pulse rate be?

Image attribution: "MF-180" by Pascal. Licensed under CC BY-SA 3.0 via Wikimedia Commons.

Image attribution: “MF-180” by Pascal. Licensed under CC BY-SA 3.0 via Wikimedia Commons.

The topic of the pulse rate is one that our patients and healthy athletes frequently like to discuss with us.

With the increased availability and ease of use of wearable monitors, the optimal exercise heart rate has become an almost universal subject of conversation, not only in the athletic community but also among those who are just embarking on an exercise program.

In general, athletes are interested in the pulse rate in 2 situations:  the resting pulse rate, best measured upon waking in the morning, and the pulse rate during sustained aerobic exercise, such as running or cycling.  Today we will address the pulse rate during exercise and leave the resting pulse rate for a separate article.

So what is the physiologic meaning of the exercise pulse rate?  Is there a pulse rate one should aim for?  What if the rate falls outside the target zone?  Can the pulse rate ever be a clue to a cardiovascular problem?  Let’s take these questions one by one.Read more

Q&A about high blood pressure during exercise

 

Please note: this article is for general information only and should not be taken as specific medical advice. Should you have any symptoms or concerns, please seek medical attention or contact us for further evaluation. If you feel you are having a medical emergency, contact 9-1-1 immediately.
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Image attribution: www.volganet.ru CC.BY.SA.3.0

The adverse effect of lack of exercise on the blood pressure is well known.  A sedentary life frequently leads to chronic hypertension, and in turn, high blood pressure can lead to heart, brain, and kidney damage.

We will address the topic of chronic hypertension in a separate article.  Today, we will discuss a phenomenon called “hypertensive response to exercise” which can occur in seemingly healthy subjects who have no history of hypertension but whose blood pressure during exercise seems to increase “too much.”Read more

Is your job affecting your heart?

 

I-love-my-work

Image attribution: Iconshock CC BY-SA 3.0

Is your job putting you at risk of a heart attack?

As you can imagine, this question has preoccupied epidemiologists and public health specialists for decades.  But despite years of research, straightforward or clear answers are not always available for specific job descriptions.  The medical literature is usually guarded in its assessment of occupational factors leading to heart disease.

Also, if a certain job is linked to an increased risk of heart disease, the job itself may not be the cause of the problem.  For example, risk factors for heart disease (such as smoking) may be more common in certain occupations than in others, making it seem like the job itself imparts the risk.

With this in mind, below are 8 findings that have emerged from years of research:

 

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Can you ever exercise too much?

Can you exercise too much

Image attribution: Julian Mason/Flickr.

Professional athletic trainer and sports journalist Ian MacMahan asked us that question as part of an article he published in The Atlantic Monthly magazine.

McMahan reported on recent research that raises concerns about ultra-endurance sports carried to an extreme level for many years.  Such an exercise regimen increases one’s chance of having arrhythmia, such as atrial fibrillation, and may also cause scarring in the ventricle of the heart.

Some cardiologists have sounded alarm bells, comparing such exercise regimens to a “toxin.”  In my opinion, it is not yet clear if long-term, high-intensity exercise alone is the cause of the problem, or if those affected have other factors that come into play.  Nevertheless, the research should not be dismissed.   Here are some highlights:Read more

Demystifying the ECG

 

ECG pulse trace

Image attribution: via Pixabay Creative Commons CC0 Public Domain

The electrocardiogram (ECG) is by far the most commonly performed cardiac test.  You may have seen a picture of one in a book or a magazine, or you may have been drawn into the drama of this mysterious waveform, flashing periodically on a monitor during a tense moment of  “E.R.” or “House.”

Have you wondered what the ECG is truly about?

The following Q&A will demystify the test as we begin to reflect on how the heartbeat comes about.Read more

Cardiomyopathy

 

Please note: this article is for general information only and should not be taken as specific medical advice. Should you have any symptoms or concerns, please seek medical attention or contact us for further evaluation. If you feel you are having a medical emergency, contact 9-1-1 immediately.

Cardiomyopathies are very common causes of exercise-related cardiac arrest in youth and young adults, but can occur to anyone at any age.  An unfortunate example is the case of a 45-year-old seasoned runner who collapsed during a marathon last November in Tennessee.  The autopsy revealed an unsuspected cardiomyopathy.Read more

Facts and nuances about cardiac screening

 

We are delighted to have been featured in a San Francisco Chronicle article which highlights the rising interest in cardiac screening among athletes.  I was correctly identified as being among the growing number of cardiologists who believe that current screening tools are excellent and underutilized.

The article covered the subject of screening in general, so I would like to offer some additional information for clarification. Read more

Coronary artery disease in simple terms

 

Please note: this article is for general information only and should not be taken as specific medical advice. Should you have any symptoms or concerns, please seek medical attention or contact us for further evaluation. If you feel you are having a medical emergency, contact 9-1-1 immediately.
What are the coronary arteries?

The coronary arteries are the blood vessels that run on the surface of the heart, bringing blood, oxygen, and nutrients to the heart muscle.  As you can see on the image below, each coronary artery has a name that corresponds to its location on the surface of the heart.Read more

Is the ‘Google Pill’ the only hope for heart disease detection?

There has been a great deal of buzz around Google’s announcement of their plan to develop a “pill” that will circulate in the blood stream to detect early forms of cancer and give warning signs about impending cardiac complications.  Thissounds like science fiction, but who knows?  We certainly wish them the best success in this endeavor.

But do we really need to wait for these futuristic projects to be able to detect heart disease early?  I wrote an Op Ed for the San Jose Mercury News which you may find informative.

Cardiac arrest during marathons: 10 facts to consider

Last Sunday, an experienced marathon runner in his mid-50’s collapsed a few yards from the finish line during the Road2Hope half-marathon in Hamilton, Ontario.  Regrettably, the paramedics were unable to resuscitate him.  This unfortunate story illustrates the rare but tragic phenomenon of exercise-induced sudden cardiac arrest.Read more