While more than 3,000 miles into a cross-country tour, I was climbing a mountain pass and felt extremely fatigued. Finished the mountain and sought medical help in the next town and was diagnosed with a heart attack! End of tour.

I had a stent put in and am now in recovery for 3 1/2 weeks. I am trying to figure out a good recovery training program. Have done very short 10 minute sessions on my trainer keeping heart rate within 30 points of my resting heart rate of 42. Am also walking up to an hour a day, 3.5 to 4 miles.

Any experiences or advice?

Bypass for me and it was a while before I could sit on the bike. Are you on Beta Blockers- because if you are- they will not allow you to raise the heart rate much under hard exercise. That is a good thing but can slow recovery to full fitness.

Walking firmly will get the heart working and keep muscle in trim. I only used to do 2 miles a day- 1 mile into town and 1 mile back but at 6mph. Worked up to that by the way and it does get you breathing very hard. I was not back on the bike for 6 weeks and thanks to the breastbone- it hurt. However at week 12 I did a 40 miler that if I knew how hard it was going to be- I would have trained for

Take it steady but keep exercising the whole body. My one problem on the 40 miler was just after the ride. I had shinsplints in both shin bones as they were not used to the hard exercise I had just given them

I'll give you my own return to form. I had a heart attack in Dec., '08. I had a stent placed in an artery. I was back on my bike in five days; it would have been less, however I was in the hospital for three days and saw my cardiologist the next day. He said to start riding and we agreed to keep my heart rate under 120 beats per minute until I had a stress test, which took place two weeks later.

I passed the stress test and immediately upped my exercise level, without fear of having another heart attack. My heart attack, by the way, was mild.
.
In August, 2009, I had two more stents placed in another artery after some angina pain; i had another seriously blocked artery. I was back on my bike, and rode as hard as I wanted, three days later. Of course, I hadn't had a heart attack.

In March, 2012, I had a more serious heart attack. My cardiologist initially said I had serious damage, later changed to less damage, later changed to "You recovered better than most people who've had a heart attack." Doctors, I think, tend to put patients into a box for treatment, instead of seeing patients as individuals who may require tailored treatment. (I have a new cardiologist.)

I took one week off from riding after that second heart attack, and definitely took my time coming back, riding just a few miles a day for a few days, and taking about a month before I started riding hard again.

So I didn't bother much with recovery time for my three coronary incidents.

I didn't bother with beta blockers or ACE Inhibitors. I have, like you, a low resting heart rate and I wasn't worried about remodeling because of the amount of exercise I was giving my heart. I'm still here and in as good a shape as ever, and I can't live forever, anyway, so if I'm forfeiting some time I might have for life by not taking a couple of drugs, so be it.

Good luck with your own recovery.

I'll bet without the bike riding, you gents would have had those heart attacks many years ago and they would have been far more severe. Keep it up, guys. It inspires the younger old guys like me.

Comtour,
Sorry to read you had a heart attack on your tour. Hope your recovery goes well and you can get back on the bike soon. Listen to your cardiologist, please.

Icyclist, your story gives much food for thought. I have a strong family history on my father's side of heart disease. Lost him at 49 to a heart attack and stroke simultaneously. What you did/do tells me that I need to stay vigilant, as I do.

Bill

I wonder what the best way to be vigilant is? IS there anyway to see if thats a lurking disaster?

Anyway Glad you are OK

Thanks!

In my case, being fit kept me alive until help came when I had my second, serious heart attack, and it certainly helped me with a fast recovery.

My dad had heart disease, too, and family history is apparently the major risk factor for having a heart attack. By the way, my second heart attack was the result of a clot forming inside one of my stents, which is usually quite rare. None-the-less, being in good shape will not guarantee protection from having a heart attack.

Being in good shape may well make the attack less severe than living a sedentary life and would likely delay when in life the attack happens.

The speed and extent of your recovery will depend at least partially on the amount of damage done to heart muscle. it is possible to have a heart attack that leaves little or no damage. Others create enough damage that it can lead into heart failure...

Cardiologist and becoming increasingly knowledgeable about recovery steps and PT type programs are becoming increasingly available to help with the recovery.

So, what does your medical team tell you? That is a good starting point.

I am on a low dose of beta blocker, mainly to ward off arrhythmia but it has lowered my resting heart rate to as low as 36. Blood pressure is also lower and that causes its own problems...can't stand up too quickly without getting light-headed. The side-effect of general fatigue is subsiding somewhat.

The heart attack was diagnosed on triponin levels... and the eventual cardiac catheterization which showed the blockage. EKGs were good in the ambulances and emergency rooms. (Plural because I was in a very remote area and was transferred by two ambulances and then a helicopter to a larger hospital). However, I was never in heavy pain, but had some nausea and aching.

Doctors said my fitness from cycling and my awareness that something was not right physically probably kept the damage minimal and makes the prognosis good. But you can't choose your genes. I guess age caught up with me.

I will continue adding to my cycling and walking. I intend to add swimming in the next week or so. Running is problematic because of tendonitis and plantar fasciitis. It is hard to raise my heart rate to my training levels, so I know that I am losing some fitness in the short-term. But I am willing to let my heart have some recovery time as recommended by the cardiologists. In the short-term, I will not be riding 10,000+ ft mountain passes with a loaded touring bike. But I will return to the scene and finish the last 800 miles of the tour, probably next year. I should be able to get in a few thousand miles in the meantime.

Which was the same point I made in my own response. The OP might have had it many years ago if not for his riding. And it would have happened walking up the stairs to McDonald's, not climbing a mountain pass on a 3000 mile bike tour!

My family history link extends much further than just my dad. His mother and father both died from heart disease/attacks, his brother has his first attack at 40, etc. I could go back further and wider but I guess y'all get the idea. Not something I dwell on at all. I held my dad while he died, made me want to do better for my wife, then fiance, so I started doing things to make my chances better. Cycling and running, when I still could, helped me a lot. Flight Surgeons told me I had a good start with the ECG results back in 1975-80.

Certainly cannot see the future but being vigilant does not mean that to me. I just do the best I can with my diet, now even more important with the Renal Failure, getting my riding time/exercise in, stopped my pipe smoking back in 2000 and work hard on reducing the stresses I encounter.

The fact two of you are able to post your experiences tell me there is something to being careful about things and acting early instead of being badly disabled or even dead. It is playing the hand you are dealt and doing the wise things with the hand. I just refuse to fold.

Bill

wow, Godspeed OP

There have been some high-profile and very fit advocates of physical activity who have died of heart attacks aat quite young ages.

Being fit is no guarantee at all. However, clotting and clogging of the arteries in the heart do seem to be key factors and can be strongly linked, I think, to diet and exercise.

Another little known factor is a genetic predisposition to clotting of the blood. Machka has it, and it was brought to light by a serious case of DVT.

There sometimes can be more to heart attacks than people think.

I wish you a speedy recovery. It is kind of sobering to think that you can be 3000 miles into a ride and that your heart wouldn't be up to just another summit. I tend to think that those of us who are in good shape can stress our hearts as much as we dare, resulting in yet greater conditioning, but obviously that's not true.

OP: Did you have any inkling in advance that you were at risk?

"I tend to think that those of us who are in good shape can stress our hearts as much as we dare, resulting in yet greater conditioning, but obviously that's not true."

A heart attack doesn't necessarily have to be caused physical stress. For example, a piece of the plaque most of us have as adults in our arteries can break off. When it does, a blood clot will form on what's left of the plaque's surface. If the clot becomes large enough, it can mostly or completely block blood flow through a coronary artery. The result: a heart attack. Less common is a spasming shut of an artery. Neither cause is related to exercise.

Welcome to the club! I had mine 18 months ago at age 61 while on a ride although didn't know it at the time. I just ran out of gas and didn't "feel right" when I got home. My wife drove me to the ER and after a quick test or two, the cardiologist told me I had one. A stent was installed and cleared the 99% blockage. Since then, I've put over 2k on my MTB and 5.4k on my road bike. I watch my diet and weight and take my meds. Things could have been much worse and I am glad to be here. Listen to your doctors and your body. I'm impressed with your mountain ride. Go finish when you can.

That's great news to hear! it doesn't sound like the heart muscle actually suffered any permanent damage.

I'm sure it will be hard to get back up to speed with the ultra low heart rate and low blood pressure to boot. But, like you say: its time to let the heart rest and recover a little. And I suspect your physician(s) will be adjusting the dosages to make them easier to live with as your heart gets back to normal.

Best of luck to you! It sounds like you know what you are doing and you've had good care. I feel certain you will do well!

Great attitude!

If you're simply holding back some to give yourself recovery time, then yes, you'll lose some fitness. If you are having trouble raising your heart rate because of beta blockers, then you aren't necessarily losing fitness, anymore than you'd gain fitness by taking a drug that sped up your heart rate while exercising.

Nicely said. It seems many people are unaware that many/most "heart attacks" are actually vascular events. When the plaque builds up to such a level that it interferes with blood flow to the heart, the heart muscle gets damaged and we call it a heart attack. Same issue when a chunk of plaque just breaks off and clogs an artery acutely. The pump was just fine, it was the pipes that created the problem.

It looks like a strong, healthy, well-exercised heart can withstand more of these vascular insults than the heart of a sedentary person. All the more reason to ride, as if any of us need another.

this thread is incredibly useful for us over 50 thanks for sharing. I had no idea one could have a heart attach while riding and just not feel right is the indication instead of the traditional stories of grabbing your chest in agony

IMO the walking that you are doing is the best ,and easiest, activity you can do for now for your recovery.

A natural walk has been found to be the most natural intended activity for the human body.

So stick a cell phone in your pocket ,grab some tunes if you want, and go out for a nicel long stroll!

That can be true for anybody -- but more so for women (nobody knows why)

My first heart attack felt at first like super-indigestion. Then I felt light-headed. Then I wanted to throw up. Noticed I was sweated. I never felt chest pain, although by the time I was in the operating room, I felt some pain radiating out towards my shoulder.

Second heart attack: super indigestion, followed by gradual pain in my chest that eventually had me in agony before help arrived.

By the way, if you think you are having a heart attack, ALWAYS call 911 if you suspect you are having a heart attack. Don't be embarrassed about calling for help, don't think you're imaging a heart attack - make the call. It's not just a matter of life and death. It's a matter of living a full life rather than half a life with a damaged heart, even if you do survive a heart attack.