Affairs of the Heart

Anyone had experience of heart attacks / problems?

TL:DR – Has anyone had a heart issue / stent and got back to full fitness with maximum efforts?

Long post so here goes

A bit of background…. I’m 41, 6’2” and around 14 stone so slightly heavier than the recommended BMI. I got in to tri around 2018 after spending most of my life cycling albeit more for commuting and weekend rides at around 21-23kph average with generally around 500m climbing. I had always been swimming, achieving a decent level at school so the only new sport for me was running, which I have grown to like slightly more

When I got to my teens I got fairly big (around 18-19 stone) and then went to Uni where activity increased but I was still fairly overweight. Stayed fairly big throughout my 20s before losing a fair bit of weight at 30 then gaining again until I took up training for triathlon.

Last Monday, I went out for a run. It was late and I was in two minds but was on a good run of consistent workouts so though I might as well get a 5k in. Off I went, slightly faster than my normal pace but not as fast as I’ve run in the last few weeks even. As I was getting to the top of the hill back to mine. I felt heartburn come on, so much slow that I had to slow down for it. Aware that I was on a decent time (for me) I half jogged the last few bits to complete the distance and stop my watch. The heartburn was bad but didn’t get any worse and as there was someone I’d just overtaken, I made sure I turned off before they passed me and then hunched over for a bit to try and regain my breath. Fearing a heart incident, I checked my watch connected to an HRM strap and showed 161 which is exactly where I would expect it to be and my pulse was fine too, no unusual beats.

I walked the 250m or so home, having to stop and sit down at one point on the way then got inside. I found that stretching eased the pain slightly but half a bottle of liquid Gaviscon and a yoghurt didn’t. I tried to east the pain for about half an hour before deciding that it’s probably a good idea to get to A&E, so ordered a taxi there.

Got there around 7.30pm , was triaged and then seen by a doctor around 10.30 by which point the pain had subsided to standard heartburn level . The doctor clearly thought I was over playing it, especially when my ECG came back as normal but sent me off to a second doctor anyway for a more through looking at. They took blood there and then around 1.30 am came back to me and took me to a side ward. He advised me that my troponin levels were at 0.1 Troponin is an enzyme that’s released when there’s trauma to the heart. I believe the standard for diagnosing heart attack is 0.4. In the side room I had a second test for troponin which showed levels of 0.216. For comparison, a proper heart attack would be in the high thousands.

People became a bit more interested then but seemingly couldn’t make sense of it – I have no family history, non-smoker, healthy, exercise, barely drink. It got to the point where the cardiac consultant was quite insistent that I must be either taking illegal drugs or steroids for my fitness. I sarcastically ask him how many people on steroids he comes across who are delighted when they finish in the top third of competitions they enter and he seemed to calm down a bit after that.

Still without answers, I was transferred to another, more comfortable holding ward for monitoring that night. By then, I just felt like I had in the past after a skin full of beer then a kebab in the evening waking up with heartburn and getting over it. By the next day, I felt completely normal again. In either case, I went to have an angioplasty to see if that would provide answers.

To cut this long story a bit shorter, they found a blockage in a branch of a branch of a branch of one of the coronary arteries. They were inclined to leave it as it was so minor but when the registrar told the consultant I was very active, he kindly put a stent in there and managed to open up 75% of the vein that was lost.

They told me I’d be on a few drugs for a year then aspirin and statins for life. I don’t plan to be on the statins for life as they aren’t great drugs and my cholesterol was good anyway. I’m conscious of my poor eating in the past and was well away from this (though I did have a Greggs for lunch that day) so my diet was good. It was diagnosed as a heart attack in the end.

Just slightly annoying as when I seem to really start getting stronger in all three sports, something comes along to stop me. Last year my garage got broken into at the beginning of lockdown and my bikes stolen, this year, I have 12 weeks over summer where I need to rehabilitate, just when I’ve never been stronger and faster on the bike! My only possible thinking is that I have had my first dose of the AstraZeneca vaccine though that was over 50 days earlier. Plus also there is room for improvement in my diet.

Anyway, thanks for reading, I’d be interested to hear anyone else’s experience of heart problems and then getting back to doing maximal and threshold efforts.

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I’ve no personal experience, but have two friends who have had heart ‘incidents’…. both have been very clear and in complete agreement that the biggest hurdle to recovery is psychological, not physical, and getting to the point of not being afraid of pushing it hard took them both a while.

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Hi yes I have had a heart issue for possibly the past 15 years or so. I want to give you a proper response but can’t right now. Will come back with something longer maybe later on today or maybe tomorrow :slight_smile:

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statins are fine at low levels (I’m on 20mg atorvastatin per day). they are also recommended to maintain good vascular health, not just to control cholesterol levels, which in your case would be a good idea.

my problem is atrial fibrillation which despite 2 ablations is still there and likely to always be. it prevents me going at full bore but doesn’t stop me being active.

FWIW - I know someone who had a similar incident to you aged 42. Top class runner (1:15 half marathon) who collapsed close to the end of a 10mile race but made it to the finish - his partner was also running and she’s an A&E sister and when she finished could immediately see he was in a bad way and called for an ambulance. Immediately into the cardiac clinic at the hospital based on her feedback and stented for a very similar reason as you. Various tests done to him subsequently but they never reached a conclusive reason why it happened.

He got back to running at a good level but he decided not to race again and just do it to keep fit - more of a mental thing I suspect than physical.

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Did you ever get round to typing it out?

Just being sat around scrolling through strava and receiving the various ride group texts is becoming a bit frustrating so it would be nice to have some hope :rofl::flushed:

Apologies this is a little late

Ok so my situation is a little different but I think that there are parallels. So over the past 15 years or so I get an exercise induced arrhythmia which over that time period has got progressively worse. Originally it would happen when I was racing very hard but now I can get it in training runs. There now does not seem to be a particular cause ie: running up a hill, sprinting, it will just suddenly happen. I can sense it when it happens and usually if I stop immediately for about 2 minutes or so it will reset itself. I can then carry on though after my run I will feel more tired than normal.
I have been to see a specialist, I am about to see another, and unfortunately they have not been able to diagnose the problem. I went for an ablation which in the end wasn’t performed because the surgeon couldn’t induce the arrhythmia. I also have a device under my chest but the problem with these is that they are looking for a jump to a designated HR which quite often I don’t meet

So what do I do about it?

I have continued to train but I am much more careful and I also race. So this year I tried to run a half marathon had the arrhythmia and had to pull out at 6 miles which was incredibly frustrating. But then recently I did a half distance triathlon which went completely to plan. I can’t explain why one worked and the other didn’t, that appears to be the random nature of the condition. I intend to carry on training and racing though I tend to focus now on longer events which are less likely to induce the event

There is lots more I can say on this. So please ask questions and apologies again for not replying sooner

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Think I’ve slightly misunderstood, but if you’re have a loop recorder and regularly experience symptoms It presumably should be fairly simple to see if there is an arrhythmia when you feel the symptoms?

If you are going into an arrhythmia that should be enough diagnostic proof regardless of what the actual HR is. Whether there’s a clear solution is a different question, especially as you’d be keen to avoid taking beta blockers, hence ablation if there is an ectopic source of activity.

Reason for asking is if there isn’t a clear arrhythmia, then at least might be some reassurance that whilst you’re feeling the symptom the heart is still staying in normal sinus rhythm.

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Back to the OP, many exercisers will develop abnormal rhythms of heart which are more common.

A heart attack is less common in our population, but of course some people even with good exercise levels, no smoker and low family risk etc will still be unlucky and have one.
They’ve treated you as a small NSTEMI given the doubling of troponins. Yes the absolute values are only mildly elevated but the change is more important.

I have no personal experience but see no reason why you can’t continue to exercise and get healthier from what you’ve said, indeed it would be recommended. The reassuring thing is your angiogram was pretty good so it’s not like you have lots of other vessels nearly critically blocked waiting to be another heart attack in a few years time.

As an aside if your angiogram was super clean, it would raise the possibility of something called Takutsubo Cardiomyopathy, but I’m sure your cardiologist will have considered that and have reasons for treating you as a heart attack.

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Also, and I’m shocked I didn’t just open with this, check out these threads:

They might not give you much advice on heart attacks, but they might show that you probably don’t want to ask us numpties for medical advice. What did your doctor say?

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Well as I always wear a HR monitor you can definitely see the effect of the arrhythmia and I have taken that to meetings. I think that if I understand loop recorders correctly then the data is only there for a short period of time unless you hit the trigger point where you then get a saved recording

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Yeah a change in HR is at least clear sign something is going on, but would still help your docs if they can try work out what the arrhythmia actually is on ECG.

People wearing fitness watches all the time has really helped me assess palpitations! Especially latest Apple watches that will even diagnose AF.

or just keep telling me I’m still in AF… :cry:

Relevant to this thread, Tim O’Donnell had a heart attack during his last race at Challenge Miami

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Almost exactly a year younger than me too :scream:.

Sorry for the lack of response to you all. Thank you for sharing all of your stories.

After a rough few weeks where I’ve found myself waking myself up in the middle of the night to make sure I’m alive, a quick phone consultation with a cardiac rehab nurse set a lot of my fears aside and things have been getting much better.

Like any good millennial and like Tim O’Donnel there, I’ve decided to document what’s happened and a route back to the middle of the pack on a YouTube channel.

I’m just getting my head around the editing software and am working on the first two videos which will mainly be talking head ones and then a bit of bike riding / running and (hopefully) cardiac rehab session on there.

Not sure if the rules allow me to post it on here but if I can, I’ll link the channel once there’s something on there if anyone would be interested?

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I’m currently dealing with an unknown breathing / heart issue.

background.

3 years ago, I went for a run on the hottest day of the year, while already dehydrated and a strange thing happened. My right arm swelled up. It was noticeably bigger than my left arm and felt swollen ( imagine an arm wrestler ). I ignored this for a couple of days, then following a discussion with a guy at work, who speculated “That’s a blood clot”, I went to the Doctors. Turns out, it was indeed a blood clot. I had a restriction between the clavicle and first rib and a blood clot had formed there, restricting the blood flow returning from my arm. Its called Thoracic Outlet Syndrome.

Long story short, it was removed several times, and kept returning. The options where risky surgery to remove the first rib, or live with it. So the blood clot is still there.

Fast forward to 2 weeks ago. I have done very little training during August. Sat watching TV and from out of nowhere, I couldn’t catch my breath. By which I mean, when taking a deep breath, I couldn’t fully expand my lungs. It felt like a physical restriction stopping my diaphragm from working properly. Freaked me out a bit. Over the coming days, it remained the same. My resting HR was as expected, but I noticed when on the treadmill that my HR at my usual steady pace was about 15 bpm higher than normal.

Then I remembered what the Cardiovascular surgeon told me 3 years ago. I’d enquired about the risk of leaving a blood clot in my arm, and whether I was at risk of a stroke or heart attack if it where to become dislodged and move around my body ( you hear about it on the news ). He assured me, that wouldn’t be the case and due to its location, it would only cause a Pulmonary Embolism. :sweat_smile:
You’ll know if it happens as you’ll have a shortness of breath he said.

So, following a visit to the GP, I’m still currently non the wiser, and still have the symptoms. I’ve been asked to collect evidence of my previous Vs current HR while on the treadmill over the next week, then i’m being referred to a respiratory specialist…
Not sure if I’m hoping for a PE diagnosis or not to be honest.
I’ll report back…

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Yikes, hope it gets sorted.

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Just be careful with the GP, if you’re in any doubt, it’s worth a trip to A&E to get it dealt with properly.

As much as I hate to say it, GPs seem to be wrong a fair bit and quite dismissive of healthy people having what are though of as unhealthy peoples’ problems. I don’t believe A&E should be the first port of call bit it seems to become a bit more like that.

Whilst my own personal example was at the stage after triage at hospital and I know they’re not GPs, I could almost feel the eye rolling going on when I suggested I may be having a heart attack and they reluctantly sent me for blood tests. Thankfully the blood tests showed differently.

The second one was the man I shared the transporter ambulance back from the cardiac catheter lab with…

He was around my age and was a keen cyclist. Whilst I don’t know how good, he was built like a cyclist, said how he loved cycling through the hills of his native Spain, had a Speedmax and was looking at buying the new Bolt, so I’d imagine he took it fairly seriously and covered a fair amount of miles.

Anyway, he’d gone to his GP as he started getting chest pain when exercising which went away when he stopped. Went to the doctor who just sent him away the first time with no treatment / advice. Second time he told him to try aspirin and the third time he was diagnosed with water on the lungs.

4 months after the first visit he finally gets an ultrasound scan of his lungs. As they’re scanning they realise it’s not fluid at all and is, in fact, a 90% blockage of his left coronary artery, which apparently is the one that kills you.

That took place in the morning, the stent was fitted in the early afternoon and late afternoon his was on his way back to another hospital to recover from his angioplasty.

A long story really but the TL;DR version is that you know your body better so make sure you cause a bit of a fuss and get checked for what you think it is. Better to be thought of as a bit of a pushy arse hole than it is to be a polite corpse.

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Is that the artery blockage that’s common in super fit people? The one that’s responsible for the “Marine drops dead playing 5 a side” stories?
With regards to my GP, she did say that although my Blood Oxygen suggested I had no issues, and the fact I’m using a treadmill at all indicates I can’t have a PE, given my level of aerobic fitness, it may be possible for me to go about my business with a small blockage and not realise, so she was happy to refer me for further investigation, which is pretty much all I wanted from her… :+1:

Think it’s known as the widow maker so pretty serious.

Tim O’Donnell had his blockage there.

Think Fabrice Muamba / Christian Erikson is and sudden collapses on the pitch during games is a different issue though.

The bloke I was with had atherosclerosis which is furring up of the arteries whereas O’Donnells and seemingly mine was having normal furring of the arteries for our age but a clump breaking off and lodging itself causing the heart attack.

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