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.

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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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Hi @edistoed.

I had a stent put in less than a week ago and am having the same questions you had after your procedure. How has your recovery gone? Did you follow a plan or go by feel? I am still overwhelmed by this and have so many questions anything you can share would be very much appreciated. Hope you are doing well and back to your “pre-blockage” self.

Little bump for aftburn. Hope you’re recovering well.

I was just starting cycling again when I got my stent 12 years ago, so not sure what my input is worth. I asked my cardiologist and my electrophysiologist (at separate appointments), a few years ago, if I have any limits because I wanted to start doing some HIIT work so I can keep up with my friends on the hills, and they both said “You don’t need to do that. Just go have some fun rides.” Of course I didn’t listen, mostly because I don’t think they understand the level of intensity I have already been riding at for several years. Hasn’t killed me yet!

Just saw this question. Several years later, I’m still above ground! My recovery went well, and within a few months, I was doing metrics and then finally a few centuries at the end of the season that year (and threw in one full-out gravel race as well). All was great until the final century, when I noticed an odd rhythm and my HR spiked higher than normal. I made it to the end, and after a week of dealing with some odd chest pains (nothing that felt like the original problem), my cardio finally put me on a Holter monitor that simply noted some very mild PVCs. They put me on the lowest dose of a beta blocker, and after about 6 months of tweaking its use, I take 1/4 of a pill every other day - this keeps the PVCs completely away.

This year was one of my better years on the bike - I did a handful of road centuries and four hard gravel races. At the final road race of the year (metric), about 5 miles from the finish, I got some more odd chest pains - again, not the same as when I had the blockage (I was going race pace HARD on this one). My cardio said it was most likely musculoskeletal related based on my description. It took about a month after that to feel “normal” again. They advised if it happened again, they’d probably stress test me, although they said I stress test myself in every race, and I’m still alive!

It’s been a long off-season for me, but I’m getting ready to start building base again for next year, where I’ve got six gravel races and at least two road races on the books.

Thank you TrainerRoad, for adding the Master’s toggle - I definitely need it, I don’t recover like I used to anymore!

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