Hi, I’ve posted this in other places over the past, but never here, and if you could take a moment from your busy day and offer me some advice I would greatly appreciate it. The short question is for many years I’ve had angina like symptoms when I ride that usually get better 30-60 minutes in and I can perform in the Z3-Z5 as I feel like I should.
First just a little background. No athletic experience in school. 44 years old, been averaging about 5K miles a year since 2011. When I was 14-15 years old I did a small local group ride, when the fast guys showed I would try to keep up, if I went hard enough I would feel my left arm start go numb just slightly.
Fast forward 25 years later this problem was showing up when not even going that hard at the beginning of a ride, the feeling of numbness would start up around 120 bpm, and sometimes progress to a squeezing pain. It would usually get better, and I found if I started an hour before everyone else with a slow warmup I could avoid it altogether.
by 2018 it was bad enough I mentioned it a PA at my small rural hospital/clinic, as I have never actually had a General Physician. The PA scheduled me a treadmill stress test. During the test I had no issues getting my heart rate up to 154 and felt zero tightness. The cardiologist seemed almost annoyed and had nothing to say other than I had a fine heart.
In 2020 I decided to hire a coach and try to get really serious about training during Covid Lockdown. The coach encouraged me to get more medical advice about my heart issue which still happened. I ended up seeing the same cardiologist. He struggled to understand why I was evening exercising as hard. He did an EKG which showed my heart had enlarged since the last one in 2018. He was confused because my Blood pressure along with all other tests were good. He thought I might have Hypertrophic Cardiomyopathy. He ordered a Nuclear Stress Test, and again during this test I had zero problem getting my Heart Rate up and no symptoms.
on my last visit to this cardiologist he said my heart was fine, The enlargement was uniform. He wanted to prescribe me beta blockers. I had a friend who was on beta blockers and he said he was unable to raise his heart rate much past the 130s. I never filled the prescription and never went back.
So I’m 100% the problem is worse for a couple days after a big ride, 200-300 TSS. I’m also certain the problem is worse when I’m not adequately hydrated. I also DON’T feel like I’m overtraining. On intervals.icu I’ve been holding a low 60s fitness score for months.
I’m strongly thinking about switching to structured training and using trainer road for indoor training this winter, but when I have tried to use structured training in the past, I struggle to hit the numbers I’m supposed to in the time I have.
Thanks for reading and appreciate any advice.