"Finishing a race with a cold or corona. I am strictly against that" - Accumulated cases of heart problems in cycling

Five professional cyclists have already had to end their careers prematurely in 2023 due to heart problems. Heinrich Haussler, current Head of Sport at BORA - hansgrohe, is one such case and his story still brings a frown to the forehead.

During the Covid-19 phase in 2022, Haussler caught the virus in the summer. A professional rider in the peloton at the time and aiming to be nominated for the World Championships in Australia, the country of his birth, Haussler took part in the Deutschland Tour during his illness and rode it to the end. As a result, heart problems kept occurring during his daily training routine and he also experienced arrhythmia during the race at the World Championships. He held on to the team car for around two minutes, but then also drove to the end of the race.

Previously, Haussler had only experienced heart problems once during training in 2020. However, as the situation did not return to normal after the World Championships in Australia, he was given a break by the team doctor. Haussler then wanted to get going again, but once again his heart threw a spanner in the works, so he was obliged to take strict rest by the team doctor. Haussler told the Badische Zeitung newspaper: "I was sitting at home on the couch. After a week, I thought: I have to go for a relaxed run. What should happen? That's when I collapsed."

He was then diagnosed with ventricular tachycardia, which ultimately put an end to his career, as it was a life-threatening cardiac arrhythmia. However, Heinrich Hausslerk is an exceptional case - another four professional cyclists, including Nathan Van Hooydonck, Wesley Kreder, Niklas Eg and Sep Vanmarcke, had to end their careers due to heart muscle abnormalities, heart attacks, arrhythmias and palpitations.

Dr. Ortwin Schäfer, head physician at BORA - hansgrohe, admits that the publications have made riders more aware. Schäfer has been involved in cycling for many years and is investigating whether professionals who ride for years under maximum stress are more susceptible to various heart problems at some point. This requires individual differentiation, he says, because the cardiovascular system is very complex and you have to look at a wide variety of parameters on a case-by-case basis. Congenital heart disease, acute myocarditis, life circumstances, medication or even possible doping are factors that need to be taken into account. Unfortunately, many riders do not disclose their diagnosis, which does not make the situation any easier.

In general, sport is "the best pill that can be prescribed", but Schäfer is also increasingly asking himself whether "high-intensity exercise over a long period of time can overstress the cardiovascular system". According to current observations in elite sport, however, an answer is not possible. There are only indications that top athletes have a two to ten times higher risk of atrial fibrillation than the normal population - depending on the results of a study. Their coronary arteries are more often calcified and there are more scarring changes to the heart muscle. The most recently affected riders, who had to end their careers, often trained with high volumes and high loads from an early age. Of course, sport is healthy, Schäfer said: "This is all the subject of current research, but nobody can say whether the curve will turn at some point."

"Having a cold or finishing a competition with coronavirus. I am strictly against that".

As the world governing body, the UCI is very well positioned when it comes to the early detection of heart problems: blood tests are carried out four times a year to determine inflammation and stress levels. Before the start of each season, each individual professional cyclist must undergo a comprehensive screening with a resting ECG and alternating annual cardiac ultrasound and exercise ECG. However, there is no definition of how a cardiac ultrasound must be carried out. "You can measure a thousand things, but standards need to be set for what is important in sport," emphasizes Schäfer. He himself also carries out a so-called strain analysis (deformation analysis of the heart) on both athletes and would like this to become mandatory as soon as possible.

The reasons for Heinrich Haussler's illness are still unclear, but one thing has now become clear to him: "Having a cold or finishing a competition with corona. I am strictly against that!" Based on the experiences that led to the end of his professional career, he would strongly recommend this to everyone, because there is still life after that.