How it started... (Looking for Cardiac Rehab info)

How it’s going…

This just happened… released from the hospital today. Went to ER yesterday for chest pain/pressure after hiking that then started happening during non-exertion. Back to the cath lab and they found my RCA badly blocked and were able to stent. I’m NOT going to ramp test for a long while. I blame the lack of an adaptive training beta invite :stuck_out_tongue:

If anyone has experience in resuming training after a stent (they went through my wrist, so no groin issues, although I won’t be able to put a lot of pressure on one hand for awhile), I’d appreciate learning how fast you were able to ramp back up to a reasonable TSS. The cardiologist cleared me to resume exercise on Monday, but I’m hesitant to do anything other than Z1/Z2 for a bit.

Thanks! Happy to still be around today - the blockage was tight enough that the cath wire insertion triggered full-blown 11/10 “say your goodbyes” pain.

Edit: shoot, now that I know you had a normal EKG and normal enzymes, I don’t know if anything I said originally below applies at all. I wouldn’t even know if your RCA narrowing had clinical significance versus incidental finding. You’d want to see notable changes in the EKG’s inferior leads in addition to the narrowing to feel confident that you found a true culprit?

Interesting, does the cardiologist know you are a cyclist and what “exercise” means to you?

I’m not a cardiologist, but my concern would be whether your recently damaged myocardium is at risk for triggering an arrhythmia. I wouldn’t be worried about the stent or thrombosis assuming you are on something like aspirin or plavix. It’s just the rhythm issue I wonder about.

It’s just a concept. When tissue gets injured, it can behave aberrantly. When a stroke hits the brain, seizures can follow.

Coronary anatomy can vary. Some people have an RCA that contributes significantly to perfusion of the left ventricle. If you start calling for cardiac output with intervals, what will happen?

They may say, don’t worry, your blood flow is good, the tissue will be fine. On the other hand, heart tissue isn’t like mucosal or cutaneous epithelium with significant regenerative capacity.

The safest bet is just taking it easy… and treat this event like breaking a hip or something, as if it derailed an entire competitive system?

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Bloody hell!

Well, get well soon! Hopefully you have many years of cycling ahead, now that’s sorted.

Good luck.

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That was my concern as well. We did have a conversation prior to the cath about what type and extent of physical activity I was accustomed to, but he didn’t appear to “speak cycling”. He did understand that I considered myself an “endurance athlete” (albeit in the MAMIL category).

I’m definitely going to start extremely slow and easy until I have my first follow-up in a month. As far as I know, there was no tissue damage noted, as it wasn’t a full blown MI, caught it in time before a complete blockage and enzymes were normal at the ER. EKG was normal as well - they actually wanted to cut me loose until I insisted to see a cardiologist.

Ah, interesting. I’m actually surprised you even got to a cath lab with a normal EKG and normal enzymes.

After consideration for alternative causes of chest pain like pulmonary embolism, I’d think you might follow with treadmill testing or something non-invasive as an outpatient. Something made the cardiologist cath you prior to discharge.

Maybe say something like hey doc, I’m planning to do workouts where I’ll be operating at >90% of my maximum heart rate for 20-30 mins each session 2 or 3 times a week, what about that? I can visualize their eyes :eyes:

Otherwise, when a patient says they “exercise” that could mean anything. I for one don’t look like a competitive cyclist by body habitus, so I’m sure my power duration curve would be underestimated by 99% of doctors.

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As am I! Based on my family history of cardiac disease and the presentation of symptoms, he said I textbook described a blockage, and that was the assumption they’d operate under until they had imaging to prove otherwise. “Something is brewing” were his words - I think I drew a very lucky straw with this doc.

I’m not sure which thread to stick this in but I thought this was a good motivational story for anyone who’s went through heart problems.
Tokyo 2020: Shanne Braspennincx wins keirin gold six years on from heart attack - BBC Sport

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