The Haywire Heart

How too much exercise can kill you, and what you can do to protect your heart

By Chris Case, Dr. John Mandrola, Lennard Zinn


The Haywire Heart is the first book to examine heart arrhythmia in athletes.

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Too much exercise can kill you. The Haywire Heart is the first book to examine heart conditions in athletes. Intended for anyone who competes in endurance sports like cycling, triathlon, running races of all distances, and cross-country skiing, The Haywire Heart presents the evidence that going too hard or too long can damage your heart forever. You’ll find what to watch out for, what to do about it, and how to protect your heart so you can enjoy the sports you love for years to come.

The Haywire Heart shares the developing research into a group of conditions known as “athlete’s heart”, starting with a wide-ranging look at the warning signs, symptoms, and how to recognize your potential risk. Leading cardiac electrophysiologist and masters athlete Dr. John Mandrola explores the prevention and treatment of heart conditions in athletes like arrhythmia, atrial fibrillation and flutter, tachycardia, hypertrophy, and coronary artery disease. He reviews new research about exercise intensity and duration, recovery, inflammation and calcification, and the ways athletes inflict lasting harm.

These heart problems are appearing with alarming frequency among masters athletes who are pushing their bodies harder than ever in the hope that exercise will keep them healthy and strong into their senior years. The book is complete with gripping case studies of elite and age-group athletes from journalist Chris Case—like the scary condition that nearly killed cyclist and coauthor Lennard Zinn—and includes a frank discussion of exercise addiction and the mental habits that prevent athletes from seeking medical help when they need it.

Dr. Mandrola explains why many doctors misdiagnose heart conditions in athletes and offers an invaluable guide on how to talk with your doctor about your condition and its proven treatments. He covers known heart irritants, training and rest modifications, effective medications, and safe supplements that can reduce the likelihood of heart damage from exercise.

Heart conditions affect hardcore athletes as well as those who take up sports seeking better health and weight loss. The Haywire Heart is a groundbreaking and critically important guide to heart care for athletes. By protecting your heart now and watching for the warning signs, you can avoid crippling heart conditions and continue to exercise and compete for years to come.

Read excerpts, take the exercise addiction quiz, and check for warning signs on The Haywire Heart page.

The Haywire Heart: How too much exercise can kill you, and what you can do to protect  your heart
Chris Case, Dr. John Mandrola, and Lennard Zinn
Paperback. Color interior with illustrations.
6″ x 9″, 320 pp., $18.95, 9781937715885

The Haywire Heart: How too much exercise can kill you, and what you can do to protect your heart

Chris Case, Dr. John Mandrola, Lennard Zinn

Paperback Two-color interior with illustrations.

Shipping Dimensions: 6in x 9in x .875in 320pp $18.95, Inventory 9781937715885, Shipping 1.125lbs

List of Illustrations



1 How the Heart Works | Case Study: Gene Kay, cross-country skier | Premature ventricular complexes

2 The Athlete’s Heart | Case Study: Jenni Lutze, triathlete | Premature ventricular complexes

3 Heart Attacks, Arrhythmias, and Endurance Athletes | Case Study: Micah True, ultrarunner | Undiagnosed

4 The Evidence | Case Study: Mike Endicott, cyclist and cross-country skier | Ventricular Tachycardia

5 What to Look for in Yourself | Case Study: Genevieve Halvorsen, cyclist | Atrial Fibrillation

6 Getting the News | Case Study: Mark Taylor, cyclist and mountaineer | Undiagnosed

7 Addiction to Exertion | Case Study: Dave Scott, triathlete | Atrial Flutter, Atrial Fibrillation

8 Treatment Options for Athlete Arrhythmia | Case Study: Paul Ernst, cross-country skier | Heart failure due to dilated cardiomyopathy

9 The Takeaway | Case Study: Jason Agosta, runner | Highly symptomatic paroxysmal atrial fibrillation






About the Authors

Preview book.

“A great resource to learn about warning signs, treatment options, and so on.” — Runner’s World magazine

“A must-read for any dedicated athlete—it examines the symptoms to watch for, what to do about your risks, and how to protect your heart so you can (safely) enjoy sports for the rest of your life.” —Triathlete magazine

“In the long term, warn the American authors of a new book, extreme exercisers could be setting themselves up for serious consequences.” — The Times

“The more exercise the better, right? Wrong, says this new book, which is the first to actually take a closer look at heart problems in athletes.” — Triathlete magazine

“The science is well explained—and backed up by color diagrams and a handy glossary…Ultimately, though, this is a hopeful book on a deadly subject.” — Experience Life

“Ultrarunners and other endurance athletes should pay attention to the main message of this fascinating book.” — Ultrarunning magazine

“The field of arrhythmias is rather complicated…but the authors have found a writing style that is captivating and accessible to the non-medical reader, while retaining much medical detail that will be of interest.” — Dr. Larry Creswell,

The Haywire Heart does give one reason to pause and consider…Anyone who does intense or long endurance training, especially over many years, should read this book.” —

“Zinn and fellow authors Chris Case and John Mandrola, a cardiac electrophysiologist and cyclist with atrial fibrillation, do a good job of looking at all the angles.” — Canadian Cycling magazine

“These authors believe that physical exercise is a positive thing, [but] they urge athletes to be realistic about the danger of pushing the limits of year heart.” — Triathlon Magazine Canada

“This book could save your life.” —

The Haywire Heart does an excellent job of walking the line between alarmism and reality…Certainly the most exhaustive look yet at the issue. Where the book really shines are in the case studies of citizen athletes who have seen their lives turned upside down.” — Madison Magazine

“If you have been diagnosed with a cardiac condition…a book like The Haywire Heart will fill in a lot of blanks for you.” — Podium Café

“I appreciate how the theme of The Haywire Heart is, ‘Let’s focus on longevity as the measuring stick of fitness, not necessarily the world record that we’re gonna hold.’” —40+ Fitness

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