Why Can a Heart Attack Suddenly Occur While Playing Cricket or Working Out at the Gym?

Dr. Shyam Sunder K R, Senior Consultant – Interventional Cardiology, Aster RV Hospital, Bangalore

A heart attack can sometimes occur suddenly during intense physical activity such as cricket, running or a gym workout, particularly in people who have an underlying heart condition that has not been diagnosed. Exercise itself is not usually the cause; rather, sudden or strenuous exertion can increase the heart’s demand for oxygen and place additional stress on the cardiovascular system.

Most common cause is coronary artery blockages, which are not severe and not diagnosed on routine treadmill testing. Those blockages which have high lipid content are prone for plaque rupture, and thrombosis (clot formation) sudden occlusion of blood vessel leading to heart attack.

Other risk factors include high blood pressure, diabetes, high cholesterol, smoking, obesity, sedentary lifestyle and a family history of premature heart disease. The risk can also increase when someone who is not accustomed to regular exercise suddenly performs high-intensity activity.

In younger people, less common causes may include inherited heart conditions, abnormalities of the heart muscle or coronary arteries, and certain rhythm disorders. Dehydration, extreme heat and the use of stimulants or certain performance-enhancing substances can also place additional stress on the cardiovascular system.

Warning symptoms may include chest pressure or pain, unusual breathlessness, excessive sweating, nausea, dizziness or pain spreading to the arm, back, neck or jaw. However, some heart attacks can occur with few or no obvious warning symptoms.

People with risk factors or symptoms should undergo appropriate medical evaluation before undertaking strenuous exercise. Regular, gradually increased physical activity is generally beneficial for heart health, but intensity should be appropriate for a person's age, fitness and medical condition.

Most common cause is coronary artery blockages, which are not severe and not diagnosed on routine treadmill testing. Those blockages which have high lipid content are prone for plaque rupture, and thrombosis (clot formation) sudden occlusion of blood vessel leading to heart attack.