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Signs of Excessive Exercise Stress

Appropriate Action(s)

1.В  pale skin

Approach person and question them about their exercise, duration and intensity, ask them how they are feeling.В  If they say they are feeling fine and they seem alert and okay just keep an eye on them.В  If not, suggest re-hydration and ceasing exercise for the day.

2.В  loss of co-ordination

Approach person and ask them to pause their exercise.  Question about intensity and duration and see how they are feeling.  If training that hard is part of their programme then suggest decreasing the intensity today and review their overall programme.  If it’s not, then have them stop, help them recover with water and sugars, and possibly recommend a doctors visit.

3.В  minimal sweating

Approach person and question them about their exercise, duration and intensity, ask them how they are feeling.В  If they say they are feeling fine and they seem alert and okay just keep an eye on them.В  If not, suggest hydration and ceasing exercise for the day.

4.В  slumped posture

Approach person and ask them to pause their exercise.  Question about intensity and duration and see how they are feeling.  If training that hard is part of their programme then suggest decreasing the intensity today and then review the overall programme.  If it’s not, then have them stop, help them recover with water and sugars, and possibly recommend doctor visit.

5.В  shallow and rapid breathing

Approach person and ask them to pause their exercise.  Question about intensity and duration and see how they are feeling.  If training that hard is part of their programme and aim (e.g. there is significant anaerobic work involved) then suggest decreasing intensity today and review the overall programme.  If it’s not, then have them stop, help them recover with rest and monitor their breathing.  Recommend a doctors visit.

Finding autopsyAge limitPossible mutated genesClass of recommendation for referral of first-degree family members for clinical/genetic counselingLevel of evidence [References]
Unknown/Uncertain cause of SCD≤ 40Mainly ion channels genesIC [58] [59, 63, 64]
Hypertrophic cardiomyopathyNo limitSarcomeric and other disease related genesIC [59, 65]
Arrhythmogenic cardiomyopathyNo limitDesmosomal and other disease-related genesIC [66]
Dilated cardiomyopathyNo limitSarcomeric, cytoskeleton and other disease-related genesIC [59]
Premature atherosclerosisMen < 40 Women< 50Familial hypercholesterolemia genesIIaC [67, 68]
Thoracic aortic aneurysm / dissection / rupture with medial degenerationUnknownSyndromic and non-syndromic aortic aneurysm-related genesIC [6971]
Spontaneous coronary artery dissectionNo limitConnective tissue disease-related genesIIaC [72]
Pulmonary embolismUnknownHereditary thrombophilia genesIIba C [73]
SUDEPUnknownOverlap with ion channel-related genesIIaC [74, 75]
TCSS-ADTCSS-ATCSS-BDTCSS-B
NTLt < ttmint′ ≤ tmaxt′ ∈ {t1, t2,⋯, tN} (0 < ti + 1ti < t1)t′ ∈ {t1, t2,⋯, tN}
NCPt′ − t + 11N1
NRP t-t+22 1 N+12 1
SSS(t′ − t + 1) log qlog qN log qlog q
BCSlog qlog q N+12logq (n + 1) log q
0
TCSS-ADTCSS-ATCSS-BDTCSS-B
NTLt < ttmint′ ≤ tmaxt′ ∈ {t1, t2,⋯, tN} (0 < ti + 1ti < t1)t′ ∈ {t1, t2,⋯, tN}
NCPt′ − t + 11N1
NRP t-t+22 1 N+12 1
SSS(t′ − t + 1) log qlog qN log qlog q
BCSlog qlog q N+12logq (n + 1) log q
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