One study is not enough
According to R. Pranevičius, at the end of August there is a kind of “calm before the storm” in polyclinics and private clinics, so he would recommend using this period for health check-ups.
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“Now the patient flow in polyclinics is definitely lower and there are almost no queues for tests. However, after a few weeks, approaching the World Heart Day on September 29 and related health campaigns, the flow usually increases. Therefore, now is a very good time to schedule heart tests and perform them without stress,” says the cardiologist.
However, according to the interlocutor, it is important to remember that rest during holidays, more regular sleep, more physical activity and time in nature can be beneficial for heart function. According to the cardiologist, tests with portable sensors – Holters – also show that a week-long or longer rest improves heart rate variability, also known as HRV. This is an indicator reflecting the balance of the autonomic nervous system.
At the same time, according to the doctor, after holidays sleep quality improves and stress levels decrease. The latter can drop by about 44% after a longer rest.
“Therefore, the end of summer is really a good time not only to check the main indicators but also to have a baseline recorded during a calm period, with which one can later compare their condition. However, even an ideal cardiogram performed after holidays does not always mean that everything is fine with the heart. The resting ECG records only a few seconds of the heart’s electrical image at that specific moment. Therefore, many people with cardiovascular system changes may get a completely normal result when performing such a test in a calm, relaxed state,” explains R. Pranevičius.
According to him, studies have found that the sensitivity of resting ECG in detecting significant coronary artery disease can range from 20 to 70%, depending on the population studied and the disease. And after holidays, this limitation can be especially relevant. If a person has just returned rested – with reduced stress and improved sleep – it is likely to reflect a different state of the body than on a usual working day.
“This situation is similar to a phenomenon well known in blood pressure measurement. The indicator may be normal in the doctor’s office, but in everyday life, under usual workload and stress, it rises significantly. The same applies to heart rate. The resting state image may not reflect what happens on working days under physical or emotional stress,” emphasizes the cardiologist.
The solution is
In September, according to the cardiologist, there is often the so-called return-to-work phenomenon, confirmed by epidemiological data. According to R. Pranevičius, statistics from many countries show that the frequency of acute cardiovascular events on the first working day, especially after a longer break, is higher than on other days of the week.
“Several factors may influence this simultaneously: disrupted sleep patterns, sudden return to intense activity, psychological stress, and circadian rhythm changes,” says the doctor.
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It is here, according to the cardiologist, that the limitation of a single test in the office becomes apparent – it records heart activity at one specific moment. But not when the problem actually arises.
“Therefore, modern long-term heart rate monitoring technologies can fill this gap. They allow monitoring heart activity for days or weeks under real everyday conditions – working, exercising, experiencing stress, or sleeping. The longer the heart is monitored, the greater the chance of capturing a rare episode of arrhythmia,” notes R. Pranevičius.
According to the interlocutor, statistics also confirm this. They show that medical long-term heart rate monitoring devices can be more effective than standard short-term tests. They detect episodic arrhythmias, such as paroxysmal atrial fibrillation, much more frequently.
“Therefore,” he continues, “I would recommend using medical long-term heart activity monitoring devices, along with visiting a healthcare facility. I would start with a basic but informative set: blood pressure measurement, cholesterol profile and blood glucose testing, resting ECG, and a conversation with a doctor about family history. It is necessary to find out whether close relatives had cardiovascular diseases or early heart attacks, strokes. These few indicators provide reliable information about risk level even for a person who does not feel any symptoms.”
The mentioned basic tests, the cardiologist assures, are only part of prevention. If there are more risk factors – high blood pressure, overweight, smoking, early heart events in the family – it is worth discussing with the doctor the possibility of longer-term heart rate monitoring.
This is also relevant if unclear symptoms were previously noticed, such as palpitations, short-term dizziness, or unusual shortness of breath. “It may be that after holidays many feel great and think there is no reason to visit a doctor. However, good well-being does not always reflect the true condition of the heart. Most risk factors – high blood pressure, cholesterol, early atherosclerosis – do not cause any sensations for a long time. Moreover, about one-fifth of heart attacks are so-called silent ones, which a person may not feel,” reminds R. Pranevičius.
Therefore, he suggests using the end of summer not only for tests but also to establish healthier habits. Regular sleep, movement, rest breaks during the workday, and a balanced diet should not remain just holiday memories.
“I would recommend consciously transitioning to the work rhythm gradually, not suddenly. It would be worth trying to maintain at least some of the habits acquired during the holidays – regular sleep, movement, healthier diet, rest breaks during the workday. And right now, while there is still a calm period and we have time, take the opportunity not only to check the heart but also to consciously decide which healthier summer habits you want to carry into autumn,” concludes the head of the Emergency Department at LSMU Kaunas Hospital.
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