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Welcome to Doctor Warrick's Podcast Channel.

Warrick is a practicing cardiologist and author with a passion for improving care by helping patients understand their heart health through education. Warrick believes educated patients get the best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love.

Hi, my name is Doctor Warrick Bishop and I'd like to welcome you to my consulting room. Today I'd like to share a story with you. A patient who was in my rooms this week asking me, "what about exercise, doc? Can I strain my heart? Can I hurt my heart through too much exercise?" Well, I think most cardiologists, and most of us would think exercise is fantastic for your heart. Go on and do what you can. And to a large degree, there is absolutely no question that we love to see people exercising for their heart health, but when I answered this question of this patient, I realised there is actually a couple of scenarios that are worth touching on. What I'd like to explain is that there are two main types of exercise. There's exercise where the body moves fluidly, where the tension in the muscles is not super high, but there's lots of movement. We call that 'isotonic exercise', and things like swimming and walking fit that category. There are situations when we exercise and the muscles are bound up and tight and contracting firmly . They're not moving fluidly. They're stiff and hard ; pulled together; bunched up. We call that 'isometric'. It's not moving; it's staying the same. So, isometric exercise is the sort of exercise like weight lifting lifting heavy weights - really heavy weights.

So if we understand isometric and isotonic you actually can do a little bit of damage to your heart. First of all with isometric exercise lifting heavy weights - we know that bench pressing and lifting large weights can increase the blood pressure dramatically. If you're doing that over and over, then in fact you're increasing shear stress; the sort of stress that comes from blood rushing past blood vessels. You're increasing the stress on the major arteries every time you do it. So there is a real possibility that shear stress could cause wear and tear in the arteries. Arteries to the neck, arteries to the heart, and the main artery of the body, the aorta. The other thing is lifting those heavy weights, putting up that blood pressure, if that's occurring too often the heart responds by thickening up. The heart gets forced to thicken as the muscles do with training.

Now, a thickened heart muscle is called left, the left side of the heart we're talking about, ventricular the main chamber of the heart that we're talking about, hyper meaning increased, trophy meaning growth or size. So left ventricular hypertrophy is a consequence of elevated blood pressures. Now that could be possible from doing too much weight lifting. So, exercise that's excessive in that isometric straining type vein could be problematic. At the other end, though, isotonic exercise is normally fantastic for you. But occasionally we see endurance athletes who are doing so much training that their heart can be damaged as well. And we know that some super elite athletes who are training for hours every day actually get changes to their heart secondary to that prolonged excessive training.

So there are documented cases of very high-ranked athletes; triathletes, who have problems with their hearts because the heart dilates as part of this long-term training regime which leads to increased cardiac output and increased blood flow back into the heart, stretching the heart over time. The heart accommodates, but it doesn't always do it healthily, and occasionally these athletes at the extreme end of exercise for endurance training can have problems with their heart. So, in summary, can you put strain on your heart through exercise? Unless you are at two extremes of the scale and where those two extreme ends of scale, you can put strain on the heart which may not be good. All the stuff in-between, particularly the isotonic exercise that we would love people to do, plus some white isometric exercise to keep central muscles and core muscles stable is just fantastic for the heart. So, be careful of the extremes in exercise. All the rest is fantastic.

I hope that answers and questions that you might have had. As always I'd like to thank you for joining me. I'd like to wish you good health and goodbye.

You have been listening to another podcast from Dr Warrick. Visit his website at www.drwarrickbishop.com for the latest news on heart disease. If you love this podcast, feel free to leave us a review.

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