The Signs, the Subtle Symptoms, and How to Advocate for Yourself
There is a dangerous assumption in endurance sport:
If you are fit, you are protected.
But that is not always true.
For male athletes over 35, the number one cause of sudden cardiac death is coronary artery disease, or CAD. It is the same disease often associated with sedentary lifestyles. The difference is "how" it presents.
Athletes do not always show the classic warning signs.
And too often, early symptoms are dismissed as overtraining, aging, or stress.
CAD in Athletes Does Not Always Look Like CAD
In the general population, heart disease is often linked to clear risk factors such as smoking, obesity, diabetes, and inactivity.
Athletes frequently do not fit that profile.
Many train consistently.
They eat well.
They feel strong.
But CAD can still develop quietly, especially in men over 35 and those with a family history of heart disease.
Training can also normalize symptoms that would otherwise raise red flags.
Fatigue becomes a tough week.
Shortness of breath becomes a hard training block.
Chest pressure becomes indigestion.
The body adapts. The warning signs get buried.
Subtle Symptoms Athletes Should Not Ignore
Even mild or occasional symptoms matter.
Watch for:
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Unusual fatigue that does not match your training load
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Shortness of breath during familiar workouts
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Chest tightness, pressure, or discomfort that comes and goes
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Jaw pain, shoulder pain, or nausea during exertion
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Dizziness or lightheadedness
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A sudden drop in performance without a clear reason
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Palpitations or irregular rhythm
If it is new, different, or unexplained, it deserves attention.
You know your baseline better than anyone.
Why Basic Testing Is Not Always Enough
Many athletes assume that if their cholesterol, ECG, stress test, or echocardiogram results are normal, their heart is fine.
These tests are important. They assess rhythm, function, and exercise response. But they do not reliably detect early coronary artery disease, particularly in well-trained athletes.
That is why advanced imaging is often discussed in higher-risk endurance populations.
Two screening tools athletes should understand:
Coronary Calcium Score
This test detects calcified plaque in coronary arteries and is one of the best early indicators of silent CAD in athletes over 35.
Coronary CT Angiography
This test directly visualizes coronary arteries and can detect early, noncalcified disease.
Access varies by region, and these tests are not necessary for everyone. But informed conversations matter.
Athletes Must Learn to Advocate Differently
One of the goals of the Kris Yip Memorial Foundation is to shift the conversation from generic prevention messaging to athlete-specific awareness.
Public health messaging tells us to exercise regularly, maintain a healthy weight, and control cholesterol.
Many athletes are already doing these things.
What is often missing is acknowledgment that intense, long-term endurance training does not equal immunity.
If something feels off:
Trust your instincts.
Speak up.
Ask deeper questions.
Advocating for yourself is not overreacting. It is strength.
A Practical Guide to Talking to Your Doctor
We have created a clear, athlete-focused guide to help you navigate this conversation confidently.
It includes:
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A red flag symptom checklist
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A script to start the conversation
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What to say if your concerns are minimized
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A breakdown of common cardiac tests and what they do and do not detect
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Screening options to ask about
Because knowing what to say removes hesitation.
And hesitation can cost time.
Download our practical guide "How to Talk to Your Doctor About Heart Screening."
Strong Is Not Safe. Informed Is
You can still train hard.
You can still chase goals.
You can still do the things that bring you joy.
But you deserve the full picture.
If this work saves one life, it is work worth doing.