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Spotting the risk of sports with check-ups

  Tuesday, 24 l 05 l 2011  Source: The Straits Times   
By: Grace Chua and Lim Yi Han

Older people, those with certain conditions should get tested first, say docs

SUDDEN death during exercise is rare here. But older runners should not take any chances and should get tested, doctors say. On Saturday, a 55-year-old businessman taking part in a 5km running event collapsed from sudden cardiac arrest and died. His family said he had been on a healthy diet and exercised regularly since being diagnosed with high blood pressure two years ago. The incidence of sudden death while exercising remains low, according to a 2007 Singapore Sports Council sports safety committee report. The report highlighted that there were 15 such deaths in 2005 and 2006 out of 32,608 total deaths in the same period, a percentage of 0.046 per cent.

Dr Ching Chi Keong, a senior consultant in cardiology and co-director of electrophysiology and pacing at the National Heart Centre Singapore, said most people do not need special screening tests before taking part in sports. The Singapore Sports Council’s sports safety committee recommends a simple self-administered questionnaire. But certain groups of people should get tested, he added: People with chest pain upon exertion, who may have coronary artery disease; or people who often black out or have a family history of sudden death, who may have hereditary heart problems. Smokers and those over 50 are also at risk.

For patients with heart muscle or heart rhythm disorders, medication can help decrease the risk of sudden death, and for some of these patients who are at particularly high risk, a small device can be implanted to regulate heart rhythm by delivering an electric jolt. As for coronary artery disease, there are many tests, such as the treadmill exercise test and CT scans.

Others include the electrocardiogram (ECG), a non-invasive test using skin electrodes to measure heartbeat. A basic ECG costs $35 to $60, while a more complex version can be $290 to $390. A coronary angiogram using high-tech scanners can be $980 to $1,300.

Dr Michael Lim, cardiologist and medical director of the Singapore Medical Specialists Centre, said he is seeing more patients who are getting check-ups before returning to or starting high-impact exercise programmes. They make up about a quarter of his practice, he said. Mount Elizabeth Hospital cardiologist Dinesh Nair stressed the importance of going for check-ups before a marathon: “Those who exercise regularly may have reduced the risk of cardiac arrest but often, they have undetected problems, so it is important that they have proper clearance from doctors.”

Avid runners The Straits Times spoke to said that apart from check-ups, maintaining a healthy diet and training are also crucial. Senior executive and avid runner Stephen Neo, 47, said runners should know their own limits, including stopping the moment they feel dizzy or feel tension in their chest. Mr Neo, who has run regularly for more than 20 years, said: “Some of us will wear pedometers to monitor heart rates so we know when to slow down, but some regular runners like to push themselves to break the ‘pain barrier’.”

Project manager Teoh Tek Khoon, 60, was lucky to survive after he collapsed from sudden cardiac arrest due to clogged arteries during a 2006 marathon. A fellow runner performed cardiopulmonary resuscitation (CPR) on him before medical care was administered. Now, Mr Teoh no longer runs marathons, but still plays badminton and swims. “If you are running a competitive marathon, you need to train for at least three months in advance,” he said.

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