Marathon & Half-Marathon
Two to five hours at a sustained pace, and here it is done in heat and humidity that push heart rate higher for the same effort.
Medically Reviewed By: Dr Paul Lim – MBBS, M.Med (Int Med), MRCP (UK), FAMS (Cardiology)
Preventive Cardiology
Reviewed by Dr Paul Lim Chun Yih
Senior Consultant Cardiologist
Hyrox Heart Check-Up Before You Race, in Singapore
Hyrox pairs eight one-kilometre runs with eight strength stations, so your heart barely gets a break — demanding rather than dangerous, for someone healthy and well-prepared. Planning to race, and wondering whether your heart has ever been properly checked? Bring your questions to Dr Paul Lim, who assesses how your heart behaves under exertion, not just at rest.
Reviewed by Dr Paul Lim Chun Yih
Senior Consultant Cardiologist
Stress Test On Site
Assessed by a Cardiologist
22+ Years of Experience
Rhythm Disorder Subspecialist
22+
Years of
Clinical Experience
Clinical Experience
Your Cardiologist
Your Assessment Is Carried Out by Dr Paul Lim
Senior Consultant Cardiologist & Cardiac Electrophysiologist
Dr Paul Lim is a Senior Consultant Cardiologist who assesses fitness for sport against the demands of the event itself rather than a generic checklist. He subspecialises in heart rhythm disorders, which is the group most relevant to sudden collapse during exercise and the hardest to catch on a resting tracing. He completed advanced fellowship training at Barts Heart Centre, London under Singapore’s HMDP award.
UK & SG
Fellowship Training
10,000+
Patient Consultations
1,000+
Ablation & Device Procedures
- MBBS (Singapore)
- M.Med (Int Med)
- MRCP (UK)
- FAMS (Cardiology)
- Fellow, European Society of Cardiology (FESC)
- Fellow, American College of Cardiology (FACC)
- Fellow, Heart Rhythm Society (FHRS)
The Format
What Hyrox Asks of Your Heart
A Hyrox race is eight one-kilometre runs, each followed by a strength station: sled push, sled pull, burpee broad jumps, rowing, farmers carry, sandbag lunges, wall balls. Running and heavy lifting ask different things of the heart, and putting them back to back is what makes the format distinctive.
Running raises your heart rate and holds it there. Heavy pushing, pulling and carrying does something else: it drives blood pressure up sharply, usually while you are straining against a held breath. Alternating between the two for the best part of an hour keeps the heart working near its ceiling with very little recovery in between.
Healthy, well-prepared athletes handle that. The concern is a heart condition nobody has found yet, the kind that causes no symptoms sitting still and only declares itself under sustained load. Narrowed coronary arteries, a thickened heart muscle, a valve problem or an inherited rhythm disorder can all sit quietly for years. Race day, hard, dehydrated, in Singapore’s heat and on the back of a poor night’s sleep, is a bad moment to find out.
Two things decide the risk: whether something is already there, and how far past your limit you push. How fit you feel answers neither.
HYROX is a registered trade mark of its owner. This clinic is not affiliated with, endorsed by or connected to the event or its organisers. The name is used here to describe what people are training for.
Who It Is For
Who Should Get Checked Before Racing
Most people training sensibly do not need an assessment first. These are the circumstances where one is worth having, and the ones where it cannot wait.
Stop training and seek medical attention
Do not train through any of these:
- You fainted, collapsed or nearly blacked out during or just after exercise
- Training brings on chest pain, tightness or pressure
- Sudden severe breathlessness far out of proportion to the effort
- A racing or irregular heartbeat during a session that will not settle afterwards
Worth being assessed before race day
Book a consultation if:
- A close relative died suddenly and young, or has an inherited heart condition
- You are over 40 and taking this on after years of little exercise
- You have high blood pressure, raised cholesterol or diabetes, or you smoke
- You have a known heart condition, a stent, an ablation or previous heart surgery
- Milder palpitations that only turn up when you train hard
- Your watch keeps showing a heart rate that does not match the effort you are putting in
Usually fine to train and race
No assessment needed first if:
- You feel well and none of the above applies
- No family history of sudden death or inherited heart disease
- You are already training consistently and adding load steadily
- Our heart rate zones and maximum heart rate guides cover the everyday version of this question
Sitting somewhere between amber and green? Book a consultation and settle it before the block of training that matters.
Other Events
Racing Something Other Than Hyrox?
The question is not specific to one event. Anything that holds your heart rate high for a long stretch raises it, and the assessment behind the answer is the same.
Triathlon
Three disciplines back to back. For many competitors the swim start is the hardest few minutes of the day, with adrenaline and a crowd on top of the effort.
Obstacle Racing
Spartan and similar formats mix running with grip, carry and climbing work, which loads the heart the same way the Hyrox stations do.
Team & Racket Sports
Football, basketball and squash bring repeated flat-out efforts with short recoveries, which is its own kind of demand.
Has a race organiser, a sports body or an employer asked you for a written opinion? That is cardiac clearance, which covers the letter itself and what to bring to the appointment.
What Happens
What the Check-Up Involves
No single test is called a Hyrox heart check. What you get is a consultation and the tests your own history and training call for.
Almost always
- A consultation covering your training, symptoms, medicines, family history and the event you are working towards
- A physical examination, including blood pressure, pulse and listening to the heart
- A resting ECG, which takes a few minutes and is read on the spot
The test that answers the exertion question
A treadmill stress test records your ECG, heart rate and blood pressure while you walk and then run at increasing effort. That is the state you are actually asking about, which is why it carries the most weight before a race. A resting ECG taken while you sit still can be entirely normal in someone whose problem only surfaces under load, so the two work together rather than as alternatives.
Added where your case needs it
2D Echocardiogram
An ultrasound of the heart, used where the muscle, its pumping strength or a valve needs to be seen. It is the test that names a thickened heart muscle. Scans are performed by female professionals.
Holter Monitor
Worn for 24 hours or longer, to catch palpitations or an on-and-off rhythm problem that comes and goes across a training week.
Blood Tests
Where cholesterol, blood sugar, thyroid or anaemia could be shaping your risk or your training response.
CT Calcium Score
A low-dose scan that finds calcified plaque in the coronary arteries before it causes symptoms. Worth considering from your forties, or earlier with a strong family history.
If a test is recommended you will be told why, and you can decide from there.
Screening Packages
Heart Screening Packages
Bundling the tests works out cheaper than arranging them one by one. For someone racing, the treadmill stress test is the piece that matters: it looks at the heart under exertion rather than at rest. Basic, Plus and Advanced each include one, while Comprehensive and Full trade it for CT imaging of the arteries themselves.
Baseline Check
Basic
$368
Comprehensive blood panel, resting ECG, and treadmill stress test. The usual starting point before a race.
View Full Details →Plus
$628
Bloods, ECG, treadmill stress test, and transthoracic echocardiogram. Adds a look at the heart muscle and valves.
View Full Details →Advanced
$878
Bloods, ECG, treadmill stress test, echocardiogram, and a CT calcium score for early plaque.
View Full Details →Comprehensive
$1,578
Bloods, ECG, echocardiogram, calcium score, and CT coronary angiogram. A thorough structural and arterial assessment.
View Full Details →Full
$1,688
Six tests covering bloods, ECG, echocardiogram, calcium score, CT coronary angiogram, and carotid ultrasound.
View Full Details →All prices shown are NETT and inclusive of 9% GST. Basic and Plus are available at both Orchard and Jurong; Advanced, Comprehensive and Full are available at Orchard only, where the CT imaging is performed on site.
Comparing all five side by side is easier on the heart screening packages page. Prefer to book tests individually? Every price is listed on the cardiology fees page, with consultations from S$130.80.
Get in Touch
Book a Pre-Race Heart Check
Training for Hyrox or a race? Book a consultation and find out where you stand before the training block that matters.
Send Us a Message
Visit Us
Where to Get a Pre-Race Heart Check in Singapore
Opening Hours
| Monday – Friday | 8:30 AM – 5:30 PM |
| Saturday | 8:30 AM – 12:30 PM |
| Sunday & Public Holidays | Closed |
By Appointment Only
Common Questions
Hyrox Heart Check-Up FAQ
Do I need a heart check before Hyrox?
Not everybody does. If you are training consistently, feel well, and have no family history of sudden death or inherited heart disease, building your load steadily is reasonable without an assessment first.
It is worth being checked if you are over 40 and coming back to hard exercise after years of little, if you have high blood pressure, raised cholesterol or diabetes, if a close relative died suddenly and young, or if you have a known heart condition. Anything that happens during exercise itself — chest tightness, blacking out, a heart rate that will not settle — means stopping and being seen, not training on.
What does a pre-race heart check involve?
A consultation covering your training, your symptoms and your family history, a physical examination, and a resting ECG. Where the question is exertion, which it usually is before a race, a treadmill stress test is added: it records your ECG, heart rate and blood pressure while you walk and run at increasing effort.
An echocardiogram is added where the heart muscle or a valve needs to be seen, and a Holter monitor where palpitations come and go and need to be caught over a day or more. There is no fixed set everyone goes through.
Is a resting ECG enough before a race?
A resting ECG is a useful starting point and it picks up a good deal, including some inherited rhythm conditions and evidence of a thickened heart muscle. Its limit is that it records you sitting still.
Someone whose problem only appears under load can have a completely normal resting tracing, which is why a treadmill stress test carries more weight when the question is a race. The two are complementary rather than alternatives. If a report has already flagged something, our guide to what an abnormal ECG means explains the terms.
Can I do Hyrox with a heart condition?
Often yes, and the answer depends entirely on which condition, how well controlled it is, and what your heart does under exertion. Many people with treated high blood pressure, a past ablation, or a stable rhythm condition train and race.
Some conditions call for a limit on intensity, and a few make competitive racing inadvisable. That is a judgement to make on your own findings rather than on a general rule, so bring your reports and your event date to a consultation.
How much does a heart check-up before a race cost in Singapore?
A consultation starts at S$130.80 at our Jurong clinic and S$218 at Orchard, with tests billed separately. A resting ECG and a treadmill stress test are the usual additions.
Where you want the whole assessment bundled, the Basic heart screening package at S$368 covers a comprehensive blood panel, a resting ECG and a treadmill stress test, which usually works out cheaper than arranging the same tests one by one. All prices are NETT and inclusive of 9% GST, and every test is listed on the cardiology fees page.
How long before race day should I get my heart checked?
Four to six weeks gives you room. Most assessments finish in a single visit, but leaving a margin means a follow-up test or a change to your treatment does not collide with your race.
A Holter monitor is the one that adds time, since it records for at least 24 hours and the report follows a few days later. If your event is sooner than that, say so when you book and we will work to the date.