Coronary artery disease is the major cause of exercise-related cardiovascular complications in adults, while in younger people the cause is congenital abnormality. About six per 100,000 middle-aged men die during exertion each year. Despite the low absolute risk of cardiac problems during exercise in previously healthy men, the death rate per hour of exercise increases as activity continues. In a study in Rhode Island, for example, the relative risk of sudden death was seven times higher during jogging than during other activities. Routine testing has been advocated to detect hypertrophic cardiomyopathy, the leading cause of sudden death.
Hypertrophic cardiomyopathy is inflammation of the heart muscle.
Yet, according to Dr. Thompson, five studies which included more than 5,000 high school and college athletes found no definite cases of hypertrophic cardiomyopathy. Similar problems plague routine testing to screen exercising adults, he writes. Despite problems with routine testing, it is recommended that all young athletes undergo a brief cardiovascular examination by a practitioner who is aware of those conditions causing exercise-related cardiac events. Many of the conditions associated with sudden death in athletes can often be detected by simple physical inspection. Physicians should inform exercising adults of the nature of cardiac symptoms, especially the fact that cardiac discomfort is often not perceived as pain but as discomfort, tightness or heartburn.