I like the idea of ´getting aware´ of certain studies, but the truth is, whatever we do it will lead us all to an end.
But I know, these studies are pinpointing how much was considered too much…yet without a clear definition.
There are guidelines in the ACSM and the WHO websites about 150min of vigorous-intensity aerobic or 300min of moderate aerobic activity.
The most annoying thing is that is nothing conclusive and only suggestive.
The method known as MAF from Dr. Maffetone has been highly acclaimed as sensible yet beneficial for high-level athletes.
For those with certain types of heart problems, the MAF method has proven to be pretty benefitial. I wish you well and hopefully you find some clearer definition of what is ´really´ too much.
True. Reading online and then telling a physician a story that hits all the right points will get you the tests in US (seriously). Just make sure they are covered by your particular insurance policy!
Lots of good advice here. And agree that being an athlete doesn’t rule out underlying heart issues (genetic, damage from former/current habits). Additionally, being an athlete at a high level can cause other issues - including Sudden Cardiac Death, which may be part of what happened to people you know.
An EKG, blood work, stress test, and various MRIs can go a long way. The first 2 may be part of a normal physical. I get an EKG and blood panel each year and every few they call for a stress test. MRIs and other tests require some complaint. I got a full battery after I was having heart issues on the bike. Extreme fatigue, palpitations, challenges going even up the stairs. I did the whole family history (there was some), and explained my symptoms. Turned out to be a viral infection in my heart. Everything else checked out, and ruling out blockages/abnormalities, was a HUGE relief.
I can’t recall where I heard/read but I’ve seen that many pros cut back substantially on their riding and typically hang up those long weeks and hard efforts earlier in life. IIRC the story said the problem is mostly focused on the MAMIL types – those of us who may not have cycled much (if at all) in our youths and are trying to make up for it in our middle & later years. I know five people in my circles who have had struggles with arythmias. Somewhere recently I read the general population sees cardiologists who are plumbers and we typically need electrician cardiologists.
This last spring I had such an event myself – I was hung over and did a ramp test. For about a week I had heart palpitations. My GP Dr. chided me and said I should have went to the ER for an EKG and she suspects it was due to dehydration or being drained of electrolytes. I’m back to normal now and am spending 6-10 hours/week mostly Z2 with some difficult stuff thrown in. I often times check Train Now’s suggestions and let that inform my ride (eg yesterday it suggested a V02 Max ride and that is what I did).
Same in Japan, I’m getting another 5- or 6-lead EKG next week (I didn’t count the wires, and it’ll be fun for the nurses to attach the probes to my hairy chest).
A couple years ago I had an incidental finding on an ultrasound for another issue which revealed a just out of normal range liver size. This led to some more tests, which eventually traced it back to an enlarged heart
Took a lot of tests and varying levels of concern on the part of various doctors, but eventually was diagnosed with Athletic Heart Syndrome
Basic take away for me was less around the condition and how it would or would not impact my life, and more on not skipping your annual physical, particularly as you age, and being an informed advocate for your own care. Many people, particularly men, have a feeling of invincibility, and not needing to see doctors regularly and this leads to late detection of problems (sometimes in the ER or the morgue, sometimes well after early symptoms have presented and treatment options are more limited). Go see your doctor, ask questions, explain your situation
Another interesting idea, which my GP presented to me when referring me to a cardiologist, was to make your care interesting to the specialists. If you can engage their curiosity on a personal level they will spend more time on your case. You have to keep in mind they are seeing dozens of similar patients a day and are human beings, so they will triage and prioritize the same as the rest of us.
The “Haywire Heart” - authored by some in that article, and discussed around here previously - is an interesting and informative read.
Lennard Zinn gave an update on his own situation ~3 years ago, describing the unsuccessful attempts to fix his own condition through surgery:
If, as appears likely, these conditions become more common as the number of people who’ve practised endurance sports for very many years increases, then hopefully knowledge, prevention and treatment options will improve in time.
This actually happened to me too; not with a riding partner, but to me myself - heart attack that stopped my heart (killed me?) for 20+ minutes. 51 years old, complete physical a month prior including scoring my risk according to the AHA cardiac risk assessment. But the kind of heart attacks that youngish people get can’t be predicted. The cardiologist acknowledged that I would have passed a treadmill test the day before. But when your artery wall cracks open due to plaque rupture, you can go from a 30% obstruction (common for a 50 year old and not alarming by itself) to 100% obstruction due to the clot that forms.
Heart attacks happen less often in people who stay physically active. But heart attacks happen more often during activity than during rest. So there is a paradox that we each have to balance. I didn’t watch your linked video yet, but I’d be surprised if anybody can draw a line and prescribe an exact amount of exercise that will keep you on the “safe” side of that paradox.
Without an issue it might be tough. I’ve had some mild heart issues. Primary care doctor did EKG and nothing showed up. She referred me to a cardiologist. Cardiologist did EKG and echo stress test. Nothing showed up. Gave me the “come back if you continue to have issues” 2 months later I went back after continuing to have mild symptoms. This time he gave me a similar “come back if it gets worse”. Needless to say I’ll be getting a new cardiologist.
I don’t thing the calcium screening are particularly expensive from what I can see.
I’m 54, ride about 10,000 miles a year and got a calcium test done on Friday. I was at the hospital about an hour and the bill ran $140, which was not covered by my insurance. The actual test took about 5 minutes.
Got the results last night. I was expecting zeros, but got the below. Doesn’t seem like anything too alarming, but I’m sure I’ll be having a talk with my DR in the next week or two. It’s easy to let yourself think that enough riding cures all cardiovascular issues, but that really isn’t the case.
Agatston total coronary artery calcium score: 21
Left Main (LM): 0
Left Anterior Descending (LAD): 0
Left Circumflex (LCx): 0
Right Coronary Artery (RCA): 21
Posterior Descending Artery (PDA): 0
Diagonal: 0
Ramus 0
Valve Sc: 0
This score places the patient at the 50th percentile compared to patients of the same age, gender, and race/ethnicity. This means that 50 percent of comparable patients have more coronary calcium than this patient.
Agatston calcium score (total) extent of atherosclerosis:
*0: normal
*1 - 10: minimal
*10 - 100: mild
*100 - 400: moderate
*> 400: heavy
I definitely agree that just riding your bike is no guarantee for a healthy heart. My cholesterol levels are good and my ekg and echo stress test were fine. But of course having symptoms, even mild, is something I want to figure out the root cause.
I do a lot of long gravel bike events so I do not at all like the idea of being in the middle of nowhere on some gravel road and having a medical emergency especially involving my heart.
I also do triathlons so not I will not do another until I sort out my heart issues as having a heart issue in the middle of a swim is also not high on my list.