Health & Wellness | The WFY Magazine – September 2025 Edition |
Exercise and the Heart: Warning Signs You Must Never Ignore
Regular exercise protects the heart. It lowers blood pressure, improves blood sugar control, lifts mood, and builds stamina. It also helps with weight management and sleep. None of that reduces the need to recognise danger signals when they appear during a workout. A small number of cardiac events do begin or worsen during physical activity. Knowing the red flags and acting quickly can save a life.
Heart and circulatory diseases remain the world’s leading cause of death. The World Health Organization estimates nearly 19.8 million people died from cardiovascular disease in 2022, with heart attacks and strokes responsible for most of these deaths. This burden falls heavily on low and middle income countries. The global picture is a reminder that prevention and rapid response matter. (World Health Organization)
In the United Kingdom the scale is visible in everyday numbers. The British Heart Foundation reports around 100,000 hospital admissions for heart attacks each year. That is roughly one every five minutes. Survival has improved greatly over decades, yet the risk remains significant, especially when symptoms are missed or dismissed. (British Heart Foundation)
This article sets out the warning signs to watch for during exercise, who is most at risk, how to act in the moment, and how to train safely without fear. The intention is practical. No drama. Just clear steps that any reader can follow.
What a Heart Attack Feels Like
Many people expect a dramatic collapse. Real life is often subtler. The most common symptom is chest discomfort. It can feel like pressure, heaviness, tightness, or squeezing. The sensation can spread to the arms, neck, jaw, back, or upper stomach. Some people feel short of breath. Others sweat, feel sick, or become light-headed. These symptoms can arrive during exercise or just after you stop. They can come and go. If the symptoms are severe, persistent, or unfamiliar to you, treat them as urgent. Call the emergency number in your country. In the UK that is 999. The faster you act, the better the outcome. (nhs.uk)
During a workout it is easy to mistake warning signs for harmless strain. A stitch, a pulled muscle, or reflux can mimic chest discomfort. Breathlessness can be from a high-intensity interval rather than the heart. There is no prize for guessing wrong. When in doubt, stop, sit or lie in a comfortable position, and ask for help.
Five Red Flags During Exercise
Use this simple rule. If a symptom is new, severe, out of proportion to your effort, or does not settle quickly with rest, take it seriously.
1. Chest pain or pressure
A feeling of weight, squeezing, or tightness across the chest is a classic signal. It may be central. It may spread to the left arm. It may spread to both arms, neck, jaw, back, or upper stomach. Any such pain that appears with effort and eases with rest needs medical attention. If it does not settle within a few minutes, treat it as an emergency. (nhs.uk)
2. Unusual breathlessness
Hard breathing is normal in hard efforts. Struggling for breath during gentle work is not. Breathlessness at rest after you stop is also concerning. If you cannot speak a short sentence that you would normally manage during that pace, consider it a warning.
3. Dizziness or faintness
Light-headedness can follow a sudden stop on a treadmill or bike. It can also signal a drop in blood pressure or an abnormal heart rhythm. If you feel faint, lie down with your legs raised and call for help.
4. Palpitations
A sudden flutter, a racing heart, or the sense that beats are skipping can point to an abnormal rhythm. Brief, isolated extra beats are common and often harmless. A sustained irregular heartbeat with other symptoms deserves urgent review.
5. Unusual fatigue or weakness
Some days feel heavy. That is normal. A sudden loss of power well below your usual level is not. If easy paces feel hard and you cannot explain it with sleep, illness, medication, or heat, do not push through. Treat it as a signal to stop and reassess.
Add the following to your checklist: cold sweat, nausea, new back or jaw pain, and sudden swelling of the feet or ankles. When these occur together with chest discomfort or breathlessness, the chance of a cardiac cause rises. (nhs.uk)
Why Exercise Can Trigger an attack
Exercise raises heart rate, blood pressure, and oxygen demand. In a healthy heart this is safe and beneficial. In a heart with narrowed arteries, sudden strain can lower the blood supply to part of the heart muscle. This can cause pain known as angina. If a plaque ruptures, a clot can block the artery and cause a heart attack. In some people, exercise can unmask an abnormal rhythm. The risk is highest during unaccustomed high-intensity bouts, in extreme heat, with dehydration, or after alcohol.
The overall risk remains low for most people. Large studies of mass participation races found cardiac arrests in the range of roughly half a case per 100,000 participants, with deaths even rarer, and a downward trend over time as on-site medical cover improved. Men are more often affected than women. These figures should reassure rather than frighten. They show that events are uncommon, but real, and that preparation and swift response save lives. (News Center, PMC)
Who Is at Higher Risk
Risk rises with age, long-standing risk factors, or known heart disease. The pattern also differs by age group.
- In younger athletes under 35 years the usual culprits are inherited or structural conditions.
- In athletes and exercisers over 35 years the most common cause of sudden cardiac death is coronary artery disease. Masters runners, cyclists, and gym users belong in this group. (PMC, Oxford Academic)
The following raise risk at any age: smoking, high blood pressure, high LDL cholesterol, diabetes, chronic kidney disease, obesity, strong family history, and long sedentary spells. The WHO lists these contributors as central targets for prevention. (World Health Organization)
Readers of South Asian heritage should note an extra layer of risk. Research in the UK shows South Asians have a higher chance of developing coronary heart disease than White Europeans, even after accounting for traditional risk factors. The British Heart Foundation has summarised data showing about a 1.7-fold higher risk overall, with diabetes and lipid patterns contributing. This does not mean you should avoid exercise. It means you should manage risk factors and pay attention to symptoms. (British Heart Foundation)
What To Do in the Moment
If you suspect a heart attack or a serious rhythm problem:
- Stop your activity immediately. Sit or lie comfortably.
- Call the emergency number in your country. In the UK that is 999. Do not drive yourself.
- Unlock doors and keep your phone nearby.
- Follow the dispatcher’s instructions.
- If an automated external defibrillator (AED) is available, ask someone trained to bring it.
- Do not wait to see if it passes when symptoms are severe, unfamiliar, or persistent. Rapid care improves survival. (nhs.uk, NHS inform)
Emergency teams will perform an ECG and vital checks as soon as you arrive. Modern chest pain guidelines in emergency care set early ECG as a priority step. That rapid assessment directs the right treatment. (AHA Journals)
How To Train Safely Without Fear
The answer to anxiety is a plan. Most people can exercise safely with a few common-sense steps.
Know your baseline.
Check your blood pressure, fasting glucose, and lipid profile. If you are new to structured training or over 40, a GP consultation is a sensible start, especially if you have risk factors.
Build gradually.
Follow the UK guidance of at least 150 minutes a week of moderate activity or 75 minutes of vigorous activity, plus muscle-strengthening work on two days. Spread activity across the week. Do not save everything for one intense weekend. (nhs.uk)
Use the talk test.
At moderate effort you can speak a sentence. At vigorous effort you can say only a few words. If you cannot say a word, you are likely overreaching.
Warm up and cool down.
Begin with 5 to 10 minutes of easy movement. Finish with a gradual drop in pace. This supports blood pressure control and lowers the risk of feeling faint.
Respect the weather.
Heat and humidity raise strain. Slow down, hydrate well, and shorten sessions on very hot days.
Protect your sleep.
Training on poor sleep raises the strain on the heart and the risk of errors and falls.
Choose your pace on the day.
If you feel unwell, have a fever, or are recovering from illness, scale back. If symptoms return with even light effort, stop and seek advice.
Wearables and Heart Warnings: Helpful, Not Final
Many readers use smartwatches or fitness trackers. These tools can flag a fast or irregular pulse. Some can generate a single-lead ECG. Evidence now shows good sensitivity and specificity for atrial fibrillation detection by consumer wearables when signals are clear.
They help prompt timely assessment. They do not replace clinical diagnosis. If your device flags an irregular rhythm, especially with symptoms like dizziness or breathlessness, seek medical review. (PMC)
Strength Work, Intervals, and the Middle Ground
Strength training is a friend to the heart when programmed sensibly. Two sessions a week that use major muscle groups support blood pressure and metabolic health. Use smooth breathing. Avoid straining through very heavy lifts, especially if you have uncontrolled hypertension.
High-intensity intervals improve fitness in short sessions. Keep intervals short at first. Allow full recovery periods. Avoid stacking too many intervals when you are tired, jet-lagged, or unwell.
The majority of weekly volume should still be at easy to moderate effort. Consistency beats heroics.
A Simple Check Plan Before You Push
Create a personal checklist.
- Do I know my blood pressure, glucose, and cholesterol numbers.
- Am I a current or recent smoker.
- Does heart disease run in the family.
- Do I have a strong reason to seek a pre-exercise ECG or stress test, such as symptoms or multiple risk factors.
- Have I built my training volume slowly over at least 8 to 12 weeks.
- Do I have an AED map for my gym or running route.
If you answer yes to risks and no to checks, book an appointment before you push harder.
Special Notes for the Indian Diaspora
People of South Asian origin carry a higher baseline risk of coronary heart disease in Western countries. Research links this to patterns of diabetes, central adiposity, lipid profiles, and genetics, with social and occupational factors also relevant. The practical message is not to exercise less. It is to screen earlier, manage blood sugar and lipids actively, and give symptoms during exertion the attention they deserve. (British Heart Foundation, PMC)
Cultural routines can help. Home cooking with less oil and salt. Regular walking groups with family and friends. Yoga for balance and flexibility. Faith or community centres that organise health checks and active events. These choices reduce risk in everyday life, not just in the gym.
When It Is Safe To Resume Exercise After a Scare
If you stopped a session because of chest discomfort, marked breathlessness, faintness, or palpitations, do not return to vigorous exercise until a clinician has assessed you. If tests are normal and symptoms are clearly non-cardiac, you can build back with easy sessions. If a cardiac cause is confirmed, your team will set a tailored plan. Cardiac rehabilitation programmes are proven to improve fitness and confidence after a heart event. Ask for a referral if one is not offered.
What Gyms, Clubs, and Event Organisers Can Do
- Train staff in basic life support.
- Place AEDs in visible spots and maintain them.
- Mark the emergency procedures clearly.
- Offer gradual induction programmes for new members.
- Encourage health checks for those returning after a long break.
Large road races have shown that planning and on-course medical cover reduce deaths even when rare arrests occur. The same principle applies to smaller venues. Preparedness turns rare events into survivable events. (News Center)
The Bottom Line
Keep moving. Exercise remains one of the best tools we have to protect the heart. At the same time, learn the signals that should make you stop. Chest pressure that spreads. Breathlessness far beyond your effort. Sudden dizziness. A racing, irregular heartbeat with weakness or faintness. If symptoms are new, severe, or persistent, call for help. Quick decisions save lives.
Your plan is simple. Know your numbers. Build gradually. Respect recovery. Carry your phone. Learn the location of the nearest AED. Share this knowledge with family and friends. You will help yourself and you may help someone else.
© The WFY Magazine | The WFY Bureau Desk |
Sources for Key Facts
- Global burden of cardiovascular disease and major risk factors. (World Health Organization)
- UK heart attack admissions and survival trends. (British Heart Foundation)
- Heart attack symptoms and emergency actions in the UK. (nhs.uk, NHS inform)
- Exercise-related cardiac arrest risk in mass events and athlete age patterns. (News Center, PMC, Oxford Academic)
- Wearables and arrhythmia detection evidence. (PMC)
- Physical activity guidelines for UK adults. (nhs.uk)
- South Asian cardiovascular risk data. (British Heart Foundation)
Disclaimer: This article is for general information for The WFY readership. It is not medical advice. Do not use it to diagnose or treat any condition. Always seek the advice of a qualified healthcare professional with any questions about your health, your medicines, or your exercise plan. If you think you or someone near you may be having a heart attack, call the emergency number in your country immediately.