Training & Nutrition - Post heart attack training.

I suffered a minor heart attack during a mtb race 2 weeks ago. The cardiologist was puzzled about this. Some of the blood assays (troponin enzymes) were slightly elevated but some other enzyme markers seemed to be in contradiction. An angiogram revealed some minor vessel damage to the coronary artery but nothing to be concerned about. He suggested I see a local cardiologist and have a treadmill test and get myself wired up for a 'breathing' treadmill test as well. Following on this I'm hoping to get a referral to a sports therapist who can give me a more balanced and structured training program, which at age 50, cannot be as demanding as at age 20, for example.

I don't know if anyone has been done this road before, but are there some suggestions you have about riding that might help? He said I must not do competitive races again, with the emphasis on ride-as-hard-as-you-want-but-rest-when-you-need-to as opposed to must-finish-no-matter-what-the-cost. I think his advice is sound. I'd like to get back into riding again in the next 2 weeks but you can appreciate I am understandably hesitant considering what did happen.

can i ask what happened during the race? did you fall off the bike? this all sounds pretty scary to me, and it's something to always think about. i just had a scare with an irregular heartbeat (i'm only 27), but the doc couldn't find anything wrong. still makes me nervous. good luck with easing back into riding and i hope you don't have any more heart issues.

I was riding on a short course of about 9km. I was one of a team of 5 doing a recent 24hr mtb race in the UK. I have diabetes (type 1). I usually carry enough provisons, but in this case I consumed most of my fluid with barely 5km logged and I was running on empty by 8km. I was short breathed which meant I had to push my bike most of the way round. At the hand-over I retired to the catering tent for something sweet to drink and eat, but I knew something was definitely wrong. I just managed to get to the first aid tent where I literally dropped my bike and collapsed into the arms of the first aid crew. I was rushed to A&E and then to the cardiology unit. In that respect, the onset was gradual but significant. If this had happened maybe 30 mins earlier when I was under the forest canopy in singletrack country, the outcome could have been very different as it would have been very difficult for the emergency team to reach me, and other riders on course would have rightly thought I'd have just fallen off.

Think of it like this. Feel for a pulse. Count one. That's all that separates you from life and death. Treat your heart with respect. If you have any doubt about your irregular beat, maybe get it thoroughly investigated.

I would NEVER suggest to someone in your health as to how to exercise when you have a heart condition. If you are that concerned, you really should be looking to the sports physician for your answers, not to folks here on the board. We have no idea what your doctor saw, nor is anyone here (except cbhungry) a doctor.

Seriously, a sports physician who really is INTO sports who knows about rehabilitation and athletes would be best for you. You should definitely make sure you have this kind of doctor, because there are doctors out there that err on the side of caution and discourage you from exercising again.

Good luck, keep us updated on how things go with that!

Koffee

Follow your cardiologist's advice. And keep that thought about one heartbeat from death well in front of your mind. The scariest thing is the heart rate monitor in ICU... if you hear that flatline, that's the last thing you're going to hear!

FWIW, I have been down the same road, but before I took up cycling. What I write here shouldn't be used as anything more than an illustration of similar personal experience.

There was almost no explicable specific reason for the attack, which happened while I was sailing. I was as smoker at the time, and the ambient temperature on the river was in the high 30s. The chest pain I had experienced over the past week increased in intensity, and I became very weak.

The angiogram showed I would end up with no significant heart muscle damage. The people at the hospital said they saw a miracle happen. It's not an experience I want to repeat. I was treated with heprin, and I was very shaky for some time after leaving hospital. I started out first walking a block or so every day, then gradually increased the distance. Then I got a bike and six months later went on a 3,500km tour.

I ride within myself. If my heartbeat is way up and my head is pounding (say on a climb), I ease off. Any pains in the chest and I back right off. My left arm isn't much use as an indicator anymore, because of various nerve damage.

I'm still alive seven years later and in much, much better shape than I've ever been, even in my 20s.

Hope things go well for you.

I'm writing to learn about your experiences returning to cycling following a mild heart attack. Despite a lifelong history (I'm 65) of doing everything right--running, hiking, biking, not overweight, no smoking, etc--I had a mild heart attack a year ago. I'm happy to report I'm now doing everything I did a year ago, but I no longer go to the track and run intervals, and my cardiologist said I can do what I want, as long as I "don't do anything stupid." I took that to mean the do-or-die stuff that you mentioned.

How are you doing? I'd love to hear your thoughts and experiences.
Bob Julyan

I think in my case riding a bicycle gave me an attitude that has far as health issues goes riding will keep me healthy. It has to an extent. I think I almost got arrogant in that thought with less then good eating habits and disregarding family history. Well this Monday I went into the hospital and had two stints placed in my heart for a 99% closed artery. I was lucky I didn’t have major attack but have to admit this had definitely caught my attention. I’m not sure why I am writing this or what great wisdom I’m trying to convey other then the obvious; the rules apply to me to. I also posted this in the 50 + rider forum. I am like you everything on me was boarder line. Until they went in and checked. I have to go back for another stint later this month and then start the cardiac rehabilitatation. It is very informative to see what others have gone through and have some idea of what to expect. Jim

I also had a heart attack 6 months ago and had three stents put in. I'am 55 and have started riding and doing 20 to 50 mile rides and was just wondering what everyone has been told as far as upper levels of heart rate and etc..

Hi, Warren,
Sorry to hear about your heart attack, but I discovered, a heart attack doesn't have to be the tragedy it used to be. In fact, last year was among the best of my life, largely because of the heart attack; it allowed me to make changes and discard some mental baggages that I had needed to do for a long time. It also has helped me enjoy life more and avoid putting things off.

Regarding the high heart rate, I was told to avoid it, but I know that numerous times while hiking, biking, running, etc. my heart rate has gotten quite high, with no ill effects. But I no longer seek a high heart rate for its own sake, and in fact I've seen information in recent biking literature that achieving a super-high heart rate shouldn't be the goal but rather a lower heart rate for the same level of exertion--and that can be achieving without busting the pump. Sounds like your 20- to 50-mile rides would be perfect.

I hope this helps. As I said, a heart attack can be a beginning, not an end.
Bob Julyan