I had a heart attack 8 years ago at age 50 during an early season 25 mile solo ride. It was a simple out-and-back ride, but I didn't feel good the whole ride out, at the turn-around I felt like I had absolutely no energy. On the ride back my hands started to tingle and go numb, I got pain in my jaw, was sweating profusely, and started to get pressure in the chest. At about the 20 mile mark there were a number of hills, when I hit the first one and was barely able to make it up in a 30-28 gear I knew that I was done, so I did the only logical thing. I stopped and called my wife. She got me home, and after about a 1/2 hour things were better but no where near normal so we headed to the ER.
The first EKG showed an elevated ST, and the initial blood work showed elevated CPK and troponin levels. This was about 2 to 2 1/2 hours after I had my first symptoms. A half hour later the next EKG was normal, but my CPK and troponin levels continued to rise. They ended up peaking near levels that they said they would consider major heart damage had occurred, but with a normal EKG they felt I was out of immediate danger. Since it was a holiday weekend they decided to have the cardiac team treat me the next day.
The next day I was in the cath lab where they had both good and bad news. The bad news was that I had 70-80% blockages in the Left Cardiac Artery, the Circumflex, and the Left Anterior Descending Artery, and the blockages were located too far apart for them to install stents in all 3 before the anesthesia wore off. The good news was they saw no major heart damage and measured the ejection fraction at 74%, both indicating I had done little damage to the heart. So the next day I went in for a triple bypass. The surgeon said they found evidence that I had clotting that likely caused the MI and I had an abnormally narrow LCA, but after they restored blood flow to the heart everything was working normally. No damage as far as he was concerned. 3 days after that I was home.
By far the most painful part was the split sternum. My surgeon knew I was active and had added a few additional wires to help stabilize it, but it still takes 3 months to heal. The first couple of weeks a sneeze would have me sitting in pain for 5 minutes, not to mention the back/shoulder pain. That was probably the worst part of the whole ordeal. They had given me both beta blockers and blood pressure medication. As a result when I stood up I'd fall down, my blood pressure wouldn't increase enough to keep blood in the head. Dumping the blood pressure med fixed that.
Cardiac rehab was interesting. They are setup to handle people who are out of shape and need to strengthen the heart. They had issues with me since my heart was already strong. Early sessions were an eye-opener - they were the first time in my life I had worked out and didn't have discomfort in my chest. As they went on they discovered I developed an abnormal heart rhythm above 145 bpm. So I now have a hard redline at 145 bpm.
It took me a while to get back on the bike, almost 10 months. It was more confidence that I could ride without issues. Thankfully a co-worker who rode, along with his wife, a sports trainer as well as a cyclist, asked me if I wanted to ride with them. We went on several short rides (10-20 miles) and a few longer rides. It was enough to get my confidence back that I could ride again.
One of the cardiologist I see is a sports specialist, and he is concerned that I'm at higher risk to develop arrhythmia. The heart attack more than doubles the risk, and athletes who exercise more the 3 hours/week have a much higher risk. As a result he wants me to keep the total hours/week under 6 hours, and no ride should be longer than 2 hours. So my days of century rides is over. I now ride a couple of 1 hour rides, typically after work (normally they would be my commuting rides) and I'll take a couple of 2 hour/35-45 mile rides on the weekend.