Many cardiac conditions evolve silently for years without any signal
Each summer, the body answers an old call to move — and for most, the heart answers with it. But cardiologists remind us that exertion does not create vulnerability; it reveals what was already there, waiting in silence. Before the season of running, diving, and cycling begins in earnest, a quiet conversation with one's own cardiovascular system — guided by specialists like Dr. Guillermo Isasti — may be the most important preparation of all. Preventive medicine asks not whether we feel well, but whether we truly are.
- The seasonal surge from inactivity to intense exercise places sudden, sharp demands on hearts that may carry hidden structural or electrical flaws — flaws that have never had reason to announce themselves.
- High-risk individuals — those over 40, with hypertension, diabetes, high cholesterol, or a family history of early cardiac disease — face the greatest exposure when they launch into new summer routines without prior evaluation.
- Warning signs during exercise such as chest pain, disproportionate breathlessness, dizziness, or loss of consciousness demand immediate cessation of activity and urgent cardiac assessment.
- For the growing number of recreational divers, a specific and underappreciated danger lurks: patent foramen ovale, present in roughly one in four people, can allow bubbles to enter the arterial system during dives, raising the risk of serious neurological decompression sickness.
- Cardiologists are advocating for consolidated, single-visit cardiovascular screenings — combining history, ECG, echocardiogram, and additional tests as needed — to give individuals clear, personalized guidance before the season begins.
Summer carries with it a familiar and powerful impulse: the sudden desire to move after months of stillness. Running, cycling, hiking, diving — the warm season invites the body back into effort. Few stop to ask whether the heart is ready for the invitation.
Cardiologists argue that this pause is worth taking. The rapid shift from sedentary life to intense physical activity creates a sharp spike in cardiovascular demand. For most people, the heart rises to meet it without incident. For others, the exertion exposes something that was always present but never tested — a structural flaw, an electrical irregularity, a silent weakness. Dr. Guillermo Isasti, a clinical cardiologist and advanced cardiac imaging specialist at Ruber Internacional, explains that preventive cardiology exists precisely for this reason: not to wait for symptoms, but to find abnormalities before they become crises. Feeling fine, he notes, is not the same as being fine.
Certain groups carry greater risk and deserve particular attention: anyone over 40 beginning a new exercise routine, and those with a personal or family history of heart disease, hypertension, diabetes, or elevated cholesterol. A thorough cardiovascular assessment typically includes medical history, an electrocardiogram, and an echocardiogram, with additional tests — stress testing, Holter monitoring, cardiac MRI, or coronary CT — added according to individual risk. The benefit of conducting all evaluations in a single visit is meaningful: it reduces uncertainty and allows for rapid, tailored recommendations.
Water sports introduce a specific concern. Approximately one in four people carries a patent foramen ovale — a small opening between the heart's upper chambers that ordinarily causes no trouble. During diving, however, it can allow tiny bubbles to cross into the arterial circulation, raising the risk of neurological decompression sickness. An echocardiogram with a bubble study can detect this condition, and for anyone planning deeper or repetitive dives, the test has become increasingly relevant.
The summer call to move is genuine and worth heeding. So too is the call to move wisely — to understand one's heart before asking it to work harder than it has in months.
Summer arrives and with it comes a familiar impulse: the sudden shift from months of relative stillness into activity. Running, cycling, paddleball, hiking, diving—the warm months invite people to move in ways they've abandoned or never tried. Few pause to ask their hearts whether they're ready.
Cardiologists say that pause matters. The jump from sedentary life to moderate or intense exercise in a short span creates a sharp spike in cardiovascular demand. For most people, the heart handles it fine. For others, the exertion reveals something that was always there, waiting silently: a structural flaw, an electrical irregularity, a weakness that had caused no symptoms because it had never been tested.
Dr. Guillermo Isasti, a clinical cardiologist and advanced cardiac imaging specialist at Ruber Internacional Centro Médico Habana and Hospital Ruber Internacional, explains that this is precisely why a cardiovascular evaluation before starting intense summer activity can be decisive. The goal of preventive cardiology is not to wait for symptoms to announce themselves. It is to identify abnormalities—structural or electrical—before they generate clinical problems. Many cardiac conditions can evolve for years without any signal that something is wrong. A person feels fine and assumes they are fine. The screening exists to challenge that assumption.
Certain profiles warrant particular attention. Anyone with a history of heart disease, high blood pressure, diabetes, elevated cholesterol, or a family history of early cardiac disease or sudden death should consider evaluation. So should anyone over 40 who is about to begin a new exercise regimen. The cardiovascular assessment is tailored to the individual, though it typically includes a detailed medical history, an electrocardiogram, and an echocardiogram. Depending on risk factors, additional tests may follow: stress testing, Holter monitoring, cardiac MRI, or coronary CT scanning. The advantage of consolidated care—conducting the clinical consultation and all necessary tests in a single visit—is that it reduces uncertainty, eliminates multiple trips, and allows for rapid, personalized recommendations.
Water sports present their own particular concern. Recreational diving has grown more popular during summer months, and with it comes a specific risk. Approximately one in four people has a patent foramen ovale, a small opening between the heart's upper chambers that usually causes no problems. During diving, however, it can allow tiny bubbles to pass into the arterial system, increasing the risk of decompression sickness affecting the nervous system. An echocardiogram with a bubble study can detect this condition. For recreational divers planning deeper or repetitive dives, this test has become especially relevant.
Isasti emphasizes that certain warning signs during exercise should never be ignored. Chest pain, breathing difficulty that seems out of proportion to the effort, dizziness, intense palpitations, or loss of consciousness are signals to stop immediately and seek cardiac evaluation. The summer invitation to move is real and valuable. The invitation to move wisely—to know your heart before you ask it to work harder—is equally important.
Notable Quotes
The objective of preventive cardiology is to identify structural or electrical abnormalities before they generate clinical problems— Dr. Guillermo Isasti, clinical cardiologist
During diving, a patent foramen ovale can allow microburbujas to pass into the arterial system, increasing the risk of decompression sickness— Dr. Guillermo Isasti
The Hearth Conversation Another angle on the story
Why does summer specifically create this risk? People exercise year-round.
Summer is when the shift happens fastest. Someone goes from months of minimal activity to suddenly running or diving or hiking in the heat. That rapid change in demand is what can expose a problem that's been silent.
But if someone has a heart condition, wouldn't they have felt something before now?
That's the misconception. Many cardiac abnormalities cause no symptoms at all. You can have a structural flaw or an electrical irregularity and feel completely normal until your heart is stressed in a new way.
So the screening is really about finding the invisible problems.
Exactly. Preventive cardiology isn't about treating symptoms. It's about identifying what's there before it becomes a crisis.
What about the diving risk you mentioned—the foramen ovale thing?
One in four people have this small opening between the heart chambers. It's usually harmless. But when you're diving and pressure changes, tiny bubbles can slip through it into your arteries. That can cause serious neurological problems.
So a simple test can prevent that.
A bubble study during an echocardiogram can detect it. For anyone planning to dive regularly, it's worth knowing.
What's the takeaway for someone reading this?
If you're over 40, or you have risk factors, or you're about to start intense exercise you haven't done in years—get evaluated first. It takes one visit. It could save your life.