Suppose a person has been exercising for years, but then gradually develops congestive heart failure.

How noticeable or rapid will the decline be in this person’s ability to exercise?

“The decline in function will depend on the pace and severity of the process that leads to a weak heart,” explains Norman E. Lepor, MD, cardiologist and Co-director, Cardiovascular Imaging, Westside Medical Imaging and Clinical Professor of Medicine at UCLA.

“Generally a patient with good cardiovascular fitness will tolerate a given amount of cardiac dysfunction than one who is in poor shape.”

What this means is that if we have two people, “A” and “B,” and “A” has been doing aerobic exercise for years, while “B” has been completely sedentary…then if both people begin developing congestive heart failure, it will be better tolerated in “A.”

Nevertheless, congestive heart failure would over time start manifesting itself to “A.”

Where will the uncharacteristic fatigue be most noticeable?

“Walking rapidly or on inclines,” says Dr. Lepor.

The progression of exercise-performance declination will be more rapid than what would normally occur from the aging process.

For example, suppose a woman has been hiking for many years, continuing to do this into her 60s and 70s.

But we can’t expect her to be as efficient in her 80s as she was in her 70s—simply due to the aging process.

There will be a natural decline in her cardiorespiratory efficacy—and she’ll notice that hiking the same mountain—the one she’s done for years—takes a bit longer, and/or requires more frequent or longer rests.

But the decline in cardiorespiratory fitness, from congestive heart failure, could also be subtle, says Dr. Lepor. It can be subtle enough to be misdiagnosed as asthma or chronic obstructive pulmonary disease, he says.

It will help to be very aware of exercise performance and capacity, and to note when you take time off from cardio exercise (due to foot injury, travel, schedule conflicts, the flu or some other non-cardiac reason).

After all, skipping aerobic workouts will result in a decline in cardiovascular function; this decline happens faster in older people.

However…the absence of congestive heart failure means that the older jogger, hiker, cyclist, hill-dasher, runner, etc., will bounce back and recover their previous stamina rather quickly (assuming that they haven’t missed so many training sessions that they’ve lost significant fitness).

Having performed over 4,000 coronary angiograms and angioplasties, Dr. Lepor has focused on prevention and treatment of coronary heart disease. 
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  

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