VIDEO: How to approach CVD screening before exercise

BOSTON — In this video, an expert talks about screening for CVD prior to exercise in several populations, as well as different approaches to activity restriction after a CVD diagnosis.

“In the general population, screening prior to exercise is generally not necessary,” Neel Chokshi, MD, MBA, medical director of the sports cardiology program at the University of Pennsylvania, said. “The main issue here is that you’re creating another barrier for an individual to participate in exercise, and so you want to minimize testing and obstacles for this patient as feasible.”

Chokshi, who presented at the ACP Internal Medicine Meeting, added that “it might be beneficial to evaluate for subclinical CVD” in some subgroups.

After a cardiovascular diagnosis, “broadly speaking, individuals might consider restriction or consultation with an expert in this space if they continue to have active symptoms, if they have a condition that may put them at higher risk for arrhythmias such as myocarditis or obstructive coronary disease, and lastly, in individuals who may have genetic conditions that are exacerbated by exercise or high-intensity exercise,” Chokshi said.

He pointed out that certain individuals with CVD or suspected CVD who do not exercise regularly but express interest in high-intensity exercise may benefit from more formal evaluations like stress testing or EKG testing.

“For most individuals, the broad takeaway is that exercise is safe and should be encouraged,” Chokshi said. “We as clinicians should help them to reach this goal because the benefits of exercise, at least in CVD, greatly outweigh the risks.”

Reference:

• Chokshi N. Exercise in the general population. Presented at: ACP Internal Medicine Meeting; April 18-20, 2024; Boston.