Is it safe to participate in marathons while suffering from low ejection fraction?

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Posted on Wed, 27 May 2015 in Hypertension and Heart Disease
Question: I have a poor left side ejection fraction after a heart attack in October. 35-45% I know that no exercise is bad, I know that 12 hours marathons are bad, how do i know the ideal "sweet spot" in between? I am 69 years old and an avid cyclist. Before the heart attack i did a few "centuries," (but had to allow all day.) Since then the most I have done is 65 miles. Carvedilol sure doesn't help!
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Answered by Dr. Ahmad Nazzal 2 hours later
Brief Answer:
Baby steps

Detailed Answer:
Dear Sir,

First I would like to thank you for reaching out for professional medical support in your case. Adapting to the life style imposed upon us by disease is not easy and needs patience and lots of support from your supervising doctor, friends and family.

As you mentioned no exercise at all is bad, but exercise has to be modified to fit your new medical condition. As a starter I advise that you report to your cardiologist and ask for an exercise stress test, you will walk on a treadmill with an EKG monitoring, keeping in mind that you do this test to determine the suitable amount of work that you can do after your heart attack. Look at it as if you are retuning yourself to the new ejection fraction of your heart this way is the safest way to do that since you will be under medical supervision.

After getting your results and knowing the safe range of your heart rate you can apply that to your workout routine, but again step by step allowing the heart to create new anastomosis ( forming new blood vessels to feed the muscle), you can buy a watch that monitors your heart rate all the time while you are working out. There are even apps that you can send the report back to your cardiologist after each workout to make sure that everything is alright.

Remember that with proper monitoring of your blood pressure and control, with the medications you are taking there will be improvement on your heart condition that is if you comply with the advises of your cardiologist. However those improvements will not bring the heart back to its fully healthy state so for now i dont recommend doing any marathon running, follow the steps i mentioned adapt your workout to the outcome of your exercise stress test and step by step push your heart a little bit in the safe range.

I hope this helped, please feel free to ask more questions.

Stay safe,
Nazzal
Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Answered by
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Dr. Ahmad Nazzal

General & Family Physician

Practicing since :2011

Answered : 343 Questions

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