Exercising Too Intensely Can Be Fatal! Know These Key Facts To Be Safe

Written by Rachel Straub
Exercising Too Intensely Can Be Fatal

Approximately every 40 seconds, an American has a heart attack. Of those who do, 86% survive (but 14% unfortunately don’t). It is well established that exercise reduces the risk of all-cause mortality (including cardiovascular events), with the evidence being irrefutable. However, as with all good things, exercising too intensely can be dangerous, with the major concern being a heart attack (or even sudden cardiac death). Biggest Loser fitness trainer, Bob Harper, recently suffered a heart attack while exercising at the gym. Luckily, he survived. However, Sheryl Sandberg’s husband wasn’t so lucky.

If you have any cardiovascular, pulmonary, or metabolic disease (or any signs or symptoms), exercising too intensely may not be safe. In other words, too intense of exercise can cause an acute cardiovascular event (such as heart attack) or even sudden death. Know these key facts, from the American College of Sports Medicine, so you aren’t next:

1. You can safely exercise at all intensities (low, moderate, vigorous) without medical clearance if you have 1 or less risk factors (see below). You must have no symptoms (or a diagnosis) of cardiovascular disease (cardiac, peripheral artery, or cerebrovascular disease), pulmonary disease (COPD, asthma, interstitial lung disease, or cystic fibrosis), or metabolic disease (diabetes, thyroid disorders, renal or liver disease).

2. You can safely exercise at ONLY low & moderate intensities without medical clearance if you have 2 or more risk factors (see below). You must have no symptoms (or a diagnosis) of cardiovascular disease (cardiac, peripheral artery, or cerebrovascular disease), pulmonary disease (COPD, asthma, interstitial lung disease, or cystic fibrosis), or metabolic disease (diabetes, thyroid disorders, renal or liver disease). If you wish to exercise vigorously, medical clearance is necessary.

3. You cannot safely exercise at ANY intensity without medical clearance if have symptoms (or a diagnosis) of cardiovascular disease (cardiac, peripheral artery, or cerebrovascular disease), pulmonary disease (COPD, asthma, interstitial lung disease, or cystic fibrosis), or metabolic disease (diabetes, thyroid disorders, renal or liver disease).

Major Symptoms For Cardiovascular Disease, Pulmonary Disease, Or Metabolic Disease*

  • Pain in the chest, neck, jaw, arms, or any area from lack of oxygen (ischemia), particularly during or after exercise
  • Shortness of breath at rest or with mild exertion
  • Dizziness, particularly during or after exercise
  • Shortness of breath when lying flat that’s relieved by sitting up
  • Ankle edema, particularly at night
  • Rapid heart rate
  • Pain in a muscle from poor blood supply that’s stressed by exercise
  • Heart murmur
  • Unusual fatigue or shortness of breath with normal activity

* If you have any of these listed symptoms, you should obtain medical clearance before continuing (or starting) any level of exercise.

Symptoms Heart Info

Cardiovascular Risk Factors (Max = 8)

  • Age: Male 45+ or Women 55+
  • Family History: History of heart problems before 55 in father or 65 in mother (or other 1st degree relatives)
  • Smoker: Current, quit within past 6 months, or ongoing exposure
  • Sedentary: Not exercising at least 3 days/wk at a moderate intensity for at least 3 months
  • Obese: BMI 30+
  • Hypertension: Systolic BP 140+ or Diastolic BP 90+ or on high-blood pressure medication
  • Dyslipidemia: LDL 130+ or HDL below 40 or on statin drugs
  • Prediabetic: Fasting blood glucose 100-125

Negative Cardiovascular Risk Factors

Negative Cardiovascular Risk Factors

Example) Consider Mary With The Following Profile:

  • 60 years old = +1
  • No family history of heart problems = 0
  • Quit smoking 3 months ago = 1
  • Exercises at moderate intensity 3+ days a week for years = 0
  • BMI of 25 = 0
  • Resting blood pressure of 130/85 (and not on medication) = 0
  • LDL cholesterol of 120 and HDL cholesterol of 65 = -1
  • Fasting blood glucose of 95 = 0
  • No symptoms or diagnosis of cardiovascular disease, pulmonary disease, or metabolic disease.

Mary’s cardiovascular risk factor sum is 1. Her +2 risk score (from smoking and age) is lowered to 1 by high HDL cholesterol. A high HDL decreases cardiovascular disease risk. Since she has no symptoms or diagnosis of cardiovascular disease, pulmonary disease, or metabolic disease (and a risk score of 1 or less), she can safely exercise at all intensities without medical clearance.

Example) Consider Jim With The Following Profile:

  • 40 years old = 0
  • Mother died of heart disease at age 60 = 1
  • Never smoked = 0
  • Exercises at moderate intensity 2 days a week = 1
  • BMI of 30 = 1
  • Resting blood pressure of 120/60 (and not on medication) = 0
  • LDL cholesterol of 120 and HDL cholesterol of 38 = 1
  • Fasting blood glucose of 95 = 0
  • No symptoms or diagnosis of cardiovascular disease, pulmonary disease, or metabolic disease.

Jim’s cardiovascular risk factor total is 4 (from family history of heart issues, sedentary, obesity, and dyslipidemia). Since he has no symptoms or diagnosis of cardiovascular disease, pulmonary disease, or metabolic disease, he can safely exercise at ONLY low and moderate intensities without medical clearance (since his risk score is 2 or above). If he wishes to start vigorous exercise, he should first obtain medical clearance from his physician.

Diagnosis of Cardiovascular Disease

Example) Consider Susan With The Following Profile:

  • 70 years old = 1
  • Both parents died of cancer in 80s = 0
  • Never smoked = 0
  • Exercises at moderate intensity 4 days a week = 0
  • BMI of 25 = 0
  • Resting blood pressure of 120/60 (and not on medication) = 0
  • LDL cholesterol of 100 and HDL cholesterol of 55 = 0
  • Fasting blood glucose of 90 = 0
  • No diagnosis of cardiovascular disease, pulmonary disease, or metabolic disease, but reports ankle edema that’s most evident at night

Susan’s cardiovascular risk factor total is 1. However, her reporting of recent ankle edema could be related to heart failure. She cannot safely exercise at any intensity without medical clearance.

Although exercise is very effective in prolonging longevity and overall wellbeing, if not used with caution (particularly in the presence of cardiovascular risk factors and/or symptoms of cardiovascular disease, for example) it can be dangerous. Know your numbers and seek medical attention if you believe you are at risk. Your body will thank you for it!

Image Credits

Featured Image: Shutterstock

In-Post Images: Shutterstock

Author

Contributor : Rachel Straub ()

This Article Has Been Published on May 23, 2017 and Last Modified on December 12, 2018

Rachel Straub, MS, CSCS, is an exercise physiologist, nutritionist, biomechanist, certified strength, and conditioning specialist, and co-author of Weight Training Without Injury: Over 350 Step-by-Step Pictures Including What Not to Do!, a multi-award winning book, which has been endorsed by major names in sports medicine, physical therapy, and professional bodybuilding. She has been featured in publications such as Reader's Digest, Psychology Today, WebMD, Livestrong, Prevention, MindBodyGreen, and Women’s Health Magazine. To learn more, visit her here: www.WeightTrainingWOI.com, Facebook, & Twitter.

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