Jan 29, 2015
Sore Chest or Something Deeper?

By Joe Giandonato, MS, CSCS

For many athletes, chest soreness is a part of life and can reveal itself during practice, games, and while working out. While chest pain can stem from local muscular fatigue of the pectoralis muscles during workouts, it may also arise from angina, a condition characterized by chest pain, which may radiate to the arms, neck, or jaw.

Angina is typically indicative of a coronary event, usually caused by blockages of the coronary arteries, resulting in a myocardial ischemia, or reduced blood flow to the heart or a myocardial infarction, or heart attack. Less commonly, coronary events can be triggered by a spasm of the artery, which disrupts or delays the perfusion of blood through the artery. These are both dangerous conditions for an athlete, and when symptoms are present, it’s critical they stop and pinpoint the cause of the pain.

Causes of a coronary event stemming from a blockage may include pre-existing risk factors such as age (older individuals are at greater risk of a heart attack), family history of coronary heart disease, high cholesterol, high blood pressure, and diabetes

Causes of a coronary event stemming from a spasm may include chronic or acute stimulant usage, exercise demands which exceed an athlete’s fitness level, and a forceful direct blow to the chest. If chest pain not associated with local muscular fatigue is experienced, the athlete should immediately discontinue their activity and seek medical attention.

Preventing a Coronary Event

Prior to engaging in an extensive strength and conditioning or fitness program, athletes should consult their physician and examine their lifestyle and family history to see if they’re at risk. In some instances, such as a family history of coronary heart disease or if a coronary event was experienced, comprehensive screening may be warranted, which usually consists of a graded exercise test, or GXT, with a 12-lead echocardiogram, or ECG, to detect symptoms of heart disease, such as ST segment depression, which may reveal ischemia, or signs such as the onset of angina.

Lifestyle and Exercise Training Modification

If coronary heart disease is suspected, the athlete may have to adopt healthier eating habits, such as decreasing their dietary cholesterol intake and increasing their daily fiber intake, or may have to incorporate more aerobic exercise, conducted at lower intensities, on a daily basis. Additionally, they may have to avoid the consumption of supplements containing stimulants. Athletes who have completed their competitive careers must ensure they remain active while eating healthy to prevent weight gain and a host of health problems that are associated with it which may trigger coronary heart disease.

Joe Giandonato, MS, CSCS, is Head Strength and Conditioning Coach and Fitness Coordinator at the Germantown Academy in Fort Washington, PA.

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