97th Podcast

Podcast Guest “It's a long road” is the expert cardiologist and runner Dimitris Stergiou. Mr. Stergiou has extensive experience in the field and many continuing educations and has specialized for two years in Sports Cardiology at the University of St. George's of London. His long involvement in sports, and especially as a long-distance runner, as well as many years of medical experience – at the level of sports clubs as well as preventive cardiac check-ups, combined with further training in Sports Cardiology in London, led to the creation of the Sports Cardiology Clinic "CardioSports" in Thessaloniki.


With Mr. Stergiou we will have an interesting discussion on various cardiological topics that are directly related to runners and in a different episode he will answer all the questions that all of you Podcast listeners have asked.

Podcast Interview Highlights “It's a long road" by Sports Cardiologist and runner Mr. Dimitris Stergiou.

Is it ok to take Tenormin (it's a pill that regulates tachycardia) and run? Without the pill my heart rate slows to 170 while on the pill it goes to 140.

Low heart rates (45 to 50) during rest is normal?
Arrhythmias – B-block pill, continues to play sports and take part in mountain races?

On the occasion of the interview with the doctor I would like you to ask him the following: I have genetic cholesterol with simultaneous use of drugs.
Do drugs have a negative effect on performance especially in big races?
And if so, in what form?
Thank you very much

Question for the cardiologist - runner: Are long distances only positive for the heart or is it harmful?

Also is it okay to take anti-inflammatories before or during a marathon?
In the Marathon, many recommend taking an anti-inflammatory or painkiller at 20km to prevent the aches and pains that follow. Do these drugs affect the heart? Is dangerous; Eg do they raise pulses? Finally, taking magnesium during the Marathon, does it have any benefit or even contraindications?

A question for the cardiologist that I would like you to ask is for people who have had chemotherapy does anything change in them? They can normally train for e.g. a marathon or do more conservatively.


From the 1st km 170+ pulses and I can do a half marathon with 180 pulses consistently. Why is this happening? Always checked by a cardiologist with normal results.

I deal with climbing on steep slopes.
A Question for the Sports Cardiologist ..
What is the ideal average heart rate in high-intensity exercise and how often should it be done?
What are the heart benefits of frequent high-intensity exercise?
For example, I am climbing on a steep slope and at a certain speed I average about 130bpm. Thanks!

At what heart rate range are we allowed to exercise? how much to push based on heart rate? according to age? I see something average heart rate 160 in 55 men and in a marathon...! Is such a burden on the heart permissible?

What is the maximum heart rate that is safe to use to calculate one's zones? The 220-year-old? Or the result of his work measurement? For example, with the formula I have a max heart rate of 170, while in the ergometer I have 195. My easy runs are at 165 (both from the ergometer and by feeling), while according to the formula it should be 130. It is really subjective and " factory setting' and the formula a general safe prediction? or are we going to extremes using the ergometer readings? I have heard both from cardiologists..(at the same time I have low blood pressure 10/6 and 55 heart rate at rest and cardiogram and ultrasound are fine)

How many times and how many hours can someone run (depending on their age) during the week without burdening the heart and circulatory system.

With how many pulses is indicative to run long distances and for how long can we move at the limit of maximum pulses

At rest I had a heart rate of 100. With running I have reached after two years 80. Is it realistic to try to drop them to 60 through running? Age 44. Generally if you can really lower your heart rate enough with running.


If in the long run running long distances will create a heart problem for us

Heartburn in runners, when is it dangerous? finally the Max Heart Rate how do we calculate it with relative accuracy? thanks!

When is bigotry in runners dangerous?
Does the Marathon cause cardiac changes? What accounts for the differences in the average heart rate of peers?

George, I would like Mr. Stergiou's opinion on whether there is a risk of cardiac arrhythmia from high-intensity training (pulses above 165) in middle age.

What is best for the heart in the long run? 1) Distances up to 10 km with variations or
2) Long distances of 15+ km at a steady pace?

What happens to the heart when a runner stops running altogether….? a long distance runner and a sprinter.

By doing hard training (interval, fartlek, etc.) at ages 40-50+ raising the heart rate quite a bit, well above the general rule of 220-age, do we ultimately help the heart develop more endurance or do we wear it out faster? Does it adapt and exercise like our other muscles, becoming stronger, or do we simply destroy it before its time?

Are there transient heart function disturbances after a marathon?
Are long distances only positive for the heart or is it harmful?
Also is it okay to take anti-inflammatories before or during a marathon?


I have moderate heart failure due to mitral valve prolapse... What should I do with my pulses...?

Hello George. I'm an "everything is a road" fanatic. I would like you to ask the cardiologist about the arrhythmia part.
1) if running and especially intense running can cause "supra ventricular block".
2) and if someone has a pacemaker, the defibrillator can be a marathon runner (not just running).
I had a pacemaker installed 12 years ago when I was 34 years old. I was an amateur soccer player. The cardiologist who put it on me forbade me to run. I got depressed. In 1 year I went to another (equally good doctor) who let me run freely. As you can see he saved me. Since then I have run 3 3:45 classics (last year)😀.and many mountain races up to 30km..thank god I never had a problem..
Arrhythmias and megacardia (with all that entails) are what concern runners.

When you have a cold / virus is running allowed or should you abstain?

How do we bounce back after coronavirus?

High blood pressure (140/95, an average value) and workouts. My own cardiologist says yes to running, no to resistance training. Is it valid or not after all?

What about athletes who: a) have stenosis of the arteries up to 50%, without stents, what restrictions are placed on their exercise and especially in terms of maximum pulses in running or cycling as well as weights and b) what are the corresponding restrictions for athletes who have suffered a heart attack (I am especially interested in MINOCA heart attack).

What about valvular diseases and endurance running?

preventive examinations

George, good evening.
For Mr. Sterius who you will have on the next episode of your very fine podcast, I would like to ask this:
How often and what kind of heart tests does a healthy runner need? (I'll do it later below)
And a 2nd question if interval training is fatiguing the heart for the benefit of performance or is it training it? Or neither?

Are there any extra heart tests needed for runners? If so which ones?

How big of a risk does any heredity play in sports and especially in running?
Runner in his 50s with a heavy family history due to paternal inheritance (heart attack/death at 63, grandfathers and uncles similarly at various ages). Who is preventively checked every year at least with full hematological/cardiology etc. tests (in addition every 5 or so he does a stress echo or fatigue test - all excellent so far). He had a coronary angiogram 12 days ago which was crystal clear. Is he at risk of doing something sudden and dangerous (up to fatal) when he runs (either fast or long distances) and puts up high heart rates (according to watch/zone) regardless of whether he himself feels a corresponding load/burden?
Is it possible that as long as he monitors himself (annual check up/etc.), at the same time works out (mainly running) and watches his diet (being a vegetarian) the risk is removed and to what extent?
What more should he do or take care of, without sacrificing his love for running and especially long distances?
Thank you very much.

Someone just starts a run... what should they do to check that everything is ok?

Good Evening. I would like to ask for an amateur runner who runs regularly and wants to participate in big races, what tests are necessary to know his health levels and possible risks?

What medical tests can we do as far as the cardiological check-up is concerned? and if there is something we ignore or don't know and should definitely be done, and if the ergometry is equally important to see some cardiac problems!

At what frequency should we do a heart check? no health issues, over 40, amateur mountain runner. Thanks!

What tests should a pre-run cardiac checkup include?

Someone who runs 1-2 marathons a year, how often should they have a cardiac check-up (cardiogram, ultrasound)...? Is there a specific protocol for athletes or each doctor decides when it should be done. I had read that for someone who doesn't have a problem, the checkup is done every 2-3 years (of course, this can change based on age), while for someone with a problem, the checkup could be yearly. Are changes created in a short period of time (6 months) so that they can be visualized in examinations?
PS: I have seen, however, in a match, the organizer asks for an opinion from a doctor no later than three months

1. What medical tests should a 40 or 50 etc. athlete undergo? years old with a free history without any symptoms?
2. Fatigue test or stress echo?
In which cases should it be done?
3. With what protocol is the fatigue test? [even if it has fallen out of favor. Shows sports image]I'm waiting for full answers because they watch the great podcast and doctors [my wife] who are a little confused about what to do.


Smoking and running. What are the effects and whether they can be combined

Goodmorning George. Because in the "street movement" there are also many smokers among us (unfortunately), although I personally know why I watched a speech on this very part while I am not a smoker, I would like you to ask him so that most of the people who do not know how much a disastrous combination is cigarette-running…..

1. Reliability of measurements: Watches, Belts, Sphygmomanometers – comparison.
2. Physical signs worrying about our state of health,

Is heart rate affected by suddenly stopping training after injury?

What does palpitations mean? Is it a sign of fatigue or something else. Does coffee make the symptom worse? What should one do about it?

When a runner noticeably reduces his training volume from 60-70km (preparation peak at 110-125km) and down to 30-40 (preparation peak at 50-60km) he creates a problem in his body (instability in the heart?). Is it the equivalent of a runner going from 50-60km a week to 0 or doesn't it work that way?

1) As part of a regular check-up, I do a fatigue test which I finish just for fun. Strangely, the cardiologist who did the test starts me off with "you (athletes) are overdoing it", "your heart walls are too big", "so you are at too much risk" and "you better stop training for a while to return your heart to normal limits". I made noise. Are these valid at all or even partially? [I am an amateur long-distance runner, in very good physical condition, with daily, intensive training, 46 years old with 55 resting contractions.]2) During exercise or in a race, what are the signs that the strain on the heart exceeds the limits and is it dangerous? What could be the worst case scenario if we go beyond these limits ie stall?

Cardiologist specialist Dimitris Stergiou
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Cardiologist Dimitris Stergiou
Address: 40 Ethnikis Amynis, Center, Thessaloniki
Phone: 2310236288
Mobile: 6944715337
E-mail: dimsterg@otenet.gr


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