While we strongly promote prevention of heart disease through screening and early detection, we also wish everyone to be educated about the symptoms that could indicate an active cardiovascular problem.

A meeting was convened in October 2012 by the American College of Cardiology’s subsection on Sports and Exercise Cardiology.  The proceedings from that meeting, entitled “Protecting the Heart of the American Athlete,” were just published.  Here are the highlights that deal with 5 common symptoms of heart disease in athletes.

1. Syncope (fainting) and collapse

Syncope is the medical term to indicate a fainting spell, meaning that someone suddenly loses consciousness, falls to the ground, and spontaneously regains consciousness.

Jan Steen (1626-1679) – The Doctor’s Visit

Although many cases of fainting are benign, the symptom should always be taken very seriously, particularly if fainting occurs during exercise.  In fact, one out of three episodes of fainting during exercise is due to a very serious underlying heart problem and requires immediate attention.

As we’ve noted before, many victims of sudden cardiac arrest had no warning symptoms before the event.  But for those who did report warning symptoms, fainting and chest pain were most frequently experienced.

2. Chest discomfort

Tightness, pain, or discomfort in or around the chest, back, neck and jaw are potential signs of heart disease, particularly if the symptoms are brought on by exercise or physical activity.  The proceedings state that even though most causes of chest pain are not cardiac in origin, “cardiac causes must be considered first…so as not to miss high-risk, potentially lethal conditions.”

Cardiac causes [of chest pain] must be considered first…so as not to miss high-risk, potentially lethal conditions.

Journal of the American College of Cardiology, 2014

3. Palpitations

Palpitations are the awareness of one’s own heartbeat.  Normally, we do not feel our heart beating in our chest.  Given that the heart beats 100,000 times in a day, that’s a good thing!  On occasion, we can be aware of brief irregularity or “skipping” of the heartbeat.

If palpitations last a second or two, happen infrequently, and are without other symptoms, then they are usually benign.  On the other hand, any sustained palpitation may indicate the presence of an underlying abnormality of the heart rhythm and requires further evaluation.

4. Shortness of breath

Shortness of breath can be due to heart disease, lung disease, being out of shape, being anemic, or other medical problems.  In general, any shortness of breath that is out of proportion to the effort applied should be investigated promptly.

5. Fatigue

We can all feel tired from time to time, due to a variety of reason: lack of adequate sleep, poor nutrition, high personal stress, etc.  However, if your fatigue is persistent, and your exercise performance is consistently below what you would expect for your training level, you should get an evaluation.  If fatigue is the only symptom, it is unlikely due to heart disease, but other serious medical conditions may be present (i.e., anemia or hormonal imbalance).

Take Home Message:

Fainting, chest discomfort, shortness of breath, palpitations, and fatigue, are the cardinal symptoms of heart disease.  I wish I could come up with an easy-to-remember mnemonic (“F.C.S.P.F.” doesn’t sound too useful…), but hopefully you now know what to bring to your doctor’s attention if at any point you experience these difficulties.

I hope you have found this article informative.  If you enjoy what we write, remember to sign up for our free monthly newsletter at the bottom of this page.

Dr. Accad