Heart Pain During Exercise: Risks and Recommendations

Pain in the heart area after exercising?

(I usually lack exercise) I used to experience chest pain after exercising.
Last month, after feeling pain, I continued to run and after about a week, the pain seemed to ease, allowing me to run longer before it started again.
However, today, a month later, when I started exercising again, the pain returned, and my overall condition seems to have worsened.
I pushed through the pain and after a while, I began to feel dizzy and lightheaded.
I am 32 years old, 176 cm tall, and weigh 60 kg.
I have previously undergone a simple ultrasound and a one-minute electrocardiogram, both of which showed no issues.
I would like to consult a doctor about my condition.
What could be causing this? Additionally, if I continue to exercise while experiencing pain, could it lead to ischemia similar to angina, resulting in cardiac fibrosis and causing harmful effects?

Xi Yan, 30~39 year old female. Ask Date: 2015/01/20

Dr. He Dongjin reply Cardiology

Hello, this is likely due to a decline in cardiopulmonary function caused by a lack of exercise, which should improve with adaptation.
If you are still concerned, please visit a cardiologist to arrange for an exercise electrocardiogram (ECG) test.
There is no need to worry about fibrosis.
Changhua Hospital cares about you.

Reply Date: 2015/01/20

More Info

Understanding heart pain during exercise is crucial, especially for individuals who have experienced discomfort while engaging in physical activity. Your situation, characterized by recurrent chest pain during exercise, raises several important considerations regarding cardiovascular health, risk factors, and the potential implications of ignoring such symptoms.

Firstly, it is essential to recognize that chest pain during exercise can stem from various causes, including musculoskeletal issues, gastrointestinal problems, or, more concerningly, cardiac conditions. Given your history of experiencing pain during exercise, it is prudent to approach this matter with caution. While you mentioned that you have undergone a simple echocardiogram and a one-minute electrocardiogram (ECG) that showed no abnormalities, it is important to note that these tests may not capture all potential issues, especially those related to coronary artery disease (CAD) or exercise-induced ischemia.

The fact that you have experienced pain that seems to improve with continued exercise, only to return later, could suggest a few possibilities. One potential explanation is that your heart may be experiencing transient ischemia, where the heart muscle does not receive enough blood flow during periods of increased demand, such as during exercise. This can lead to symptoms similar to angina, which is characterized by chest pain or discomfort due to reduced blood flow to the heart muscle. Ignoring these symptoms and continuing to exercise could indeed pose risks, including the potential for more severe cardiac events, such as a heart attack, especially if there is an underlying coronary artery blockage.

Moreover, you expressed concern about the possibility of causing long-term damage to your heart, such as fibrosis, by pushing through the pain. While occasional discomfort may not lead to immediate harm, consistently exercising through significant pain could exacerbate underlying issues. Chronic ischemia can lead to myocardial damage over time, and it is crucial to listen to your body and seek medical advice rather than risk further complications.

Given your age (32 years) and relatively healthy weight (176 cm, 60 kg), it is less likely that you have severe coronary artery disease; however, risk factors such as family history, smoking, hypertension, or hyperlipidemia should be considered. If you have any of these risk factors, it would be wise to undergo further evaluation, such as a stress test or a more comprehensive cardiac assessment, to rule out significant coronary artery disease.

In terms of recommendations, here are a few steps you should consider:
1. Consult a Cardiologist: Given your symptoms, it is advisable to see a cardiologist who can perform more detailed assessments, including a stress echocardiogram or a nuclear stress test, to evaluate how your heart responds to exercise.

2. Avoid Pushing Through Pain: It is crucial to listen to your body. If you experience chest pain, dizziness, or any other concerning symptoms, stop exercising immediately and seek medical attention.

3. Monitor Your Symptoms: Keep a detailed record of when the pain occurs, its intensity, duration, and any associated symptoms (like dizziness or shortness of breath). This information can be invaluable for your healthcare provider.

4. Consider Lifestyle Modifications: If you are currently inactive, consider gradually increasing your activity level under medical supervision. Engaging in low-impact exercises, such as walking or swimming, may be beneficial while you assess your cardiovascular health.

5. Regular Check-ups: Ensure you have regular check-ups with your healthcare provider to monitor your heart health, especially if you have risk factors for cardiovascular disease.

In conclusion, while it is commendable that you are attempting to return to an active lifestyle, it is essential to prioritize your heart health and address any concerning symptoms with a healthcare professional. Ignoring chest pain during exercise can lead to serious consequences, and proactive management is key to ensuring your long-term well-being.

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