Amidst the sunny weather and outdoor activities, many people are heading out for mountain climbing to enjoy the lush season.
However, hasty mountain climbing can be detrimental for middle-aged individuals with ischemic heart disease or conditions such as angina or myocardial infarction.
The increased cardiovascular workload during climbing not only leads to chest pain but also elevates the risk of cardiac emergencies.
In fact, according to data from the Korea National Park Management Corporation, among the 69 fatal accidents that occurred during climbing from 2017 to 2021, approximately 51% (39 cases) were attributed to deaths caused by heart disease.
As reported by overseas studies, the probability of experiencing sudden cardiac death while mountain climbing is about four times higher than individuals of the same age.
Ischemic heart disease is a condition where there is a problem with the coronary arteries that supply oxygen and nutrients to the heart, resulting in inadequate blood supply to the heart. Angina and myocardial infarction are typical manifestations of this condition.
Professor Park Chang-beom from the Department of Cardiovascular Medicine at Gangdong Kyung Hee University Hospital explains, “Climbing is a high-intensity activity conducted in cold environments, particularly at high altitudes with low oxygen levels. Engaging in extensive physical activity in such conditions can lead to dehydration, and as a result, the activation of the sympathetic nervous system, causing increased heart rate, blood vessel constriction, and elevated blood pressure, among other physiological changes.” He added that these physiological changes can increase the cardiovascular workload, leading to symptoms such as chest pain.
Furthermore, stable angina manifests only when engaging in such intense physical activity, making it even more reassuring and easy for individuals to embark on climbing.
Professor Yu Jin-soo from Samsung Seoul Hospital's Transplant Surgery department emphasizes the importance of accurate diagnosis for ischemic heart disease as it is divided into stable angina, unstable angina, and acute myocardial infarction." He added that stable angina occurs when the heart does not receive adequate blood supply during activities that heavily stress the heart, such as mountain climbing. It often manifests as chest pain when insufficient blood supply is inadequate, while individuals usually remain asymptomatic daily, leading to a lack of awareness."
He continues, "However if stable angina is not properly managed, it can progress to acute coronary syndrome, where chest pain can occur even at rest, independent of physical activity. Moreover, a portion of the cardiac muscle may die, which can be life-threatening."
Therefore, individuals with ischemic heart disease need to be adequately prepared for mountain climbing, in terms of regular healthcare and during the actual climbing activity. Professor Park suggests, "Instead of sporadic intense exercise such as climbing, it is better to condition the body through regular aerobic exercises, at least 3-4 times a week, and enjoy climbing once the body is adapted." He emphasizes the importance of self-regulating intensity and speed during climbing, as well as sufficient hydration and periodic rest.
Familiarizing oneself with emergency response measures during mountain climbing is also advisable. Automatic external defibrillators and other efforts to handle cardiac arrest situations have recently been made available along hiking trails. It is recommended to take prescribed medications regularly and be prepared with sublingual nitroglycerin (an acute chest pain reliever) for emergencies.
