Heart Disease and Cycling

[cycleheart05]

Dear Forum members,

I'm an enthusiastic cyclist. I felt some tightness in my chest and I made an appointment for a physical exam. The doctor did an ekg test in office and said it looked abnormal and scheduled a stress test. At the stress test the doctors did an ultrasound of my heart then had me get on a treadmill. While I was still in the walking phase on the treadmill the cardiologist halted the test due to abnormal readings. The doctors did the final ultrasound of my heart and the cardiologist said the ultrasound confirmed the abnormal readings during the stress test and with long faces they told me I had a problem. I never felt any different during the stress test than I normally do. They recommended I get an angiogram to find out the extent of the problem. An angiogram will involve sliding a plastic tube into my groin and snaking it up to my heart. The doctors inject die which will show the extent of the blockage in the coronary arteries. While they have the tube inside me if they think they can fix blockage problems they will do angioplasty. Angioplasty involves inflating a balloon in the blocked areas to widen the artery. Afterwards they install a stent. A stent is a metal spring that holds your artery open. Before stents the agioplasty balloon would widen your arterty but the artery would narrow back down very quickly in a high percentage of cases. A stent reduces the chances that narrowing will reoccur but the doctors say it does not eliminate it because the trauma of widening your artery with the balloon causes scaring which can fill the artery even with a stent holding it open.

The doctors told me angiogram/agioplasty is very safe and the risk of death is a miniscule .2%. I disagree with thier characterization. .2% mortality says that for every 1,000 people who undergo the procedure on average 2 people die. That means there is a 1 in 500 chance I will die during the procedure. From my point of view I would characterize the procedure as exceedingly risky. I would not take a gun with 500 chambers and load it with one bullet and place it to my temple and pull the trigger for any amount of money. The doctors say there is no alternative noninvasive means of assessing coronoary artery blockage. I asked them about CAT scans MRI's and nuclear cardiology and they said the technology has been two years away for the last 10 years. They tell me the problem is that your heart moves while they take the pictures and your breathing causes your body to move so they can't get clear enough pictures.

My alternative is to forgo any procedures. What is the risk I will die of a sudden heart attack? I've read in can be as high as 1 in 10 every year if the blockage is severe. I'm not overwieght and I have a thin build. I've been an athlete all my life and I exercise considerably more than anyone else I know because I enjoy it. But I've been sendentary over the last year because of injuries. There's no heart disease anywhere in my family and my grandparents all lived into their 80's. I do have high cholesteral about 265. No one else in my family has high cholesterol I realize now I should have been out walking everyday this past year to get more exercise. How do I assess my risk of dying if I forgo any procedures? I can change my diet and elimnate all saturated fats as Dr. Dean Ornish recommends in his famous heart book which I'm getting familiar with. He claims his diet will reverse blockage. I don't know if his theories have held up or not. I can try to get on the thin side and lose some wieght and I am taking aspirin and colestrerol drugs.

I think the actual risk of me dying by letting the doctors do their procedures is higher. A failed stent could close down requiring another angioplasty procedure with another 1 in 500 chance of dying. Maybe the blockage they find would require coronary bypass surgery. What is the risk of dying during bypass surgery? It seems like that path is fraught with risk and it scares me. I can hardly bear the thought of a tube snaking its way up to my heart while I'm wide awake with an imminent heart attack possible at any moment.

I'm between a rock and a hard place. I can roll the dice and take that 1 in 500 shot to the temple next week by submiting to the angiogram and hope everything turns out well. One doctor told me if they find one artery blocked and everything else looks pristine they can put in a stent and I may never have another problem. I think the doctor said if more than one artery is blocked and it requires more than one stent mortality doesn't improve that much over doing nothing. People agree to multiple stents during the procedure because not many people who are told they have 70% blockage of two arteries respond by saying leave it be.

Or I can forgo any procedures and let the wheel of fortune spin every day until the grim reaper finally wins and comes to claim another soul. I'm 44 years old. What should I do?

[Sandy]

I have a twin brother who is a cardiologist and internist, so I will show this post to him and get his opinions. As a layman, the .2% mortality rate seems high to me. There are a very large number of angiograms done, and I have never heard of a death from one. If 1 out of every 500 individuals taking one died from the procedure, I would think that we, the public, would hear about such sometimes. Is the .2% a risk for mortality , or complications/side effects?

Personally (with the understanding that I know little in the area), I think that it would not be wise to simply roll the dice. You would live with a fear of the unknown and that would be a negative aspect of your life, and very possibility a detriment to your life. I would want to get a more definitive understanding of precisely what is wrong; i.e. the exact extent of the problem. 44 is certainly not very old to have a know heart problem. To leave it totally alone does not seem, to me, to be a very wise path.

As said before, I will show this to my brother. He seems to have clear understandings of what one shoud do and not do in medical situations.

Sorry to hear about your problem.


Sandy

[Sandy]

My brother-in-law had the procedure and to him it was not difficult, nor did it have any side effects. He had major heart disease, but died from cancer, at a young age.

Your post is exceptionally well written. Very clearly stated.

Sandy

[soulspinner]

It is likely that the .2 percent may have died anyway, remember they have heart disease and they were likely in worse shape than you. You are young and you will come through fine. The docs will also have you on something to lower your cholesterol and you will probably only have 35 more years to live.

[marle]

What you want to know are answers to questions:

(1) what is the mortality rate for 44 year old males that have untreated blocked arteries?

(2) what is the mortality rate of 44 year oldmales that undergo the proceedure cited by you?

The 1 in 500 are average odds. You want better information oin the marginal odds which apply to your case.

Best wishes!!

[Sandy]

Not only that, the odds are are always changing, and undobtedly improving in a more favorable manner, with much improved anesthesiology, improvements in angiogram techniques, and improved capability for handling any adverse effects. Medicine is ever changing and improving rapidly. Statistics are outdated at the time that they are reported.

Sandy

[marle]

Great point by Sandy -- the data is out of date.

Again good luck

Marc

[BarryG]

If you are certain that you won't have the angioplasty under any conditions, then perhaps you can opt to just have the angiogram alone if your doctor will agree. This would tell you the extent of the blockage and then you could go away and consider your options.

Personally, I'd allow the angioplasty if I were in your shoes.

FWIW, I'm not surprised by the .2% mortality risk. When you're dislodging plaque in arteries there's always going to be a risk of something breaking free and embolizing.

[Ginger]

As always: get a second opinion.

I find it odd that they wouldn't do a cardiac calcium scoring CT scan of the caridac arteries. My family has a high risk for heart disease so I had one two years ago when I was having some odd heart-related issues. The pictures looked pretty dang clear to me.

At least you might have an idea of how many arteries were possibly blocked.

If you have insurance to cover it (and perhaps even if you don't...my insurance didn't cover it) you might want to have one done.

Even if you don't have the procedure done, there are things you can do yourself to help the situation. They aren't easy, and involve entire lifestyle and diet changes, but they can help the situation. So you wouldn't just be "waiting for the big one." You'd be actively fighting it.

I think that might be the reason the medical community goes for the surgical solution in some cases. They can fix the problem where the patient they're looking at probably doesn't have the determination to do so themselves. And in reality, most people don't have the determination to follow the extreme changes they have to make for the rest of their lives. One or two years, sure, but for the rest of forever? Not so much. So often surgery is the most effective method of fixing the problem.

[jerk]

bub-
get a second opinion. the math ain't right. although if you think about it the odds are really not all that important. you're either 100% alive or a 100% dead right?

go see a cardiologist who specializes in atheletes...the jerk has found alot of doctors don't know what the hell they arte seeing when they're examining older athletes becuase everything is off the charts.

jerk

[TimB]

Heart disease is rampant in my family....
Both grandfathers died of heart attacks, one at age 54 and the other at age 62.
My father had his first heart attack at age 38, and had bypass surgery at age 50.
My mother had a heart attack at age 57, and had a stent inserted which has performed wonderfully for 8 years.
My older brother had angioplasty and had stents installed last year to open two arteries - at age 43. No complications, and he's doing great.

Are you on meds for your high cholesterol?

If it were me, I'd take the 0.2% risk - the odds in my family are pretty clear, too many deaths at relatively early ages from heart disease. Heart disease is more frightnening to me than an operation that was performed over 1,000,000 times last year in the US.

[Kevan]

to your body to have yourself checked. Continue to listen to it, it's next announcement might be a little more pronounced.

Go for another opinion, then if everything stacks up.. go for the overhaul.

[breste]

Hi there

Steve from South Africa here. I am a clinical Pathologist and also recently had an angiogram done due to a strong family history so I feel well qualified to answer your questions/concerns.

1. Reading the clinical description of your symptoms, I don't think you have a choice - it sounds as though you were showing ischaemic changes on the ECG (due to relative lack of oxygen to a portion of the heart muscle) which HAS to be followed up or you could quite simply have a massive heart attack one day while riding your bike - and then it is too late. Let me assure you that relative to the risk of doing nothing, the risk of the angiogram causing problems is TINY! This is how I would (and did) go about it:

2. Have a non-invasive angiogram (CT) first. The technology is available (as I had one done here) which was very accurate and obviously safe. They will also do a calcium score of the coronary arteries to assess extent of coronary artery disease and therefore possible future problems.

3. If there are abnormalities/narrowing of one or more of the coronary arteries (usu associated with a raised Ca score), you can proceed to an invasive angiogram after consulting your cardiologist. As long as he does them all the time there should be no problem. Based then on his angiogram findings (which you directly visualise as well), he may proceed to do an angioplasty/stent which can be a life-saving procedure!! At least then you can go into the future with all the facts and make an informed decision on the way forward. To gamble on being thin and fit with no family history is really pushing your luck with those symptoms. My brother was thin and fit with no family history (then) and had a heart attack and bypass graft at age 31!! It's not worth the gamble - trust me.

4. Evaluate ALL your risk factors e.g. full lipogram (chol/trig/LDL/HDL) as well as lipoprotein (a) and homocysteine. Also improve diet, exercise, and DON'T smoke! If necessary, cholesterol lowering meds like Lipitor should be taken.

I have babbled on enough - hope it helps (PS - got an Ottrott a couple of months ago - will post pics as soon as fully built - it's a BEEAUTT!!

Look after yourself - I mean that!! ;)

Regards
Steve the cyclenut

[2LeftCleats]

I'm an internist and deal with this nearly every day. Given your age, classic symptoms, and abnormal stress test, your risk of having heart disease is quite high. You can do other non-invasive tests as suggested, but let's say one of them is normal. Which do you believe? The strategy should not be to continue testing until you get the result you want, but to clarify the diagnosis. When other test(s) are abnormal, the catheterization is currently considered the 'gold standard'. If the cath is normal after an abnormal stress test (which does occur occasionally), it means that the stress test was probably wrong. Catheterization is routine, especially if you're in a facility that does a lot of them. If a blockage is discovered, a stent can usually be placed at the same time, taking care of the problem. Of course, that's only the beginning. Once coronary disease is identified, your physician will insist on good blood pressure and cholesterol control to prevent other blockages from occuring. Sometimes, if there is a blockage which is enough to cause symptoms, but not extremely critical, controlling blood pressure and cholesterol can reduce the block and the symptoms. But I think if you're having pain with the exertion of cycling, you'd better not screw around. You have significantly greater risk of death or impairment from an undiagnosed blockage than the cath.

[CalfeeFly]

First I'd have it done and the sooner the better. I have known very fit people die from blocked arteries that they didn't recognize.

The story is a cyclist not a runner. I saw him at a meeting in the fall, sat down next to him and said, "How was your summer." His reply was, "I died."

Turns out he was doing Ragbrai and usually cycled about 5 to 8 thousand miles a year. He had the good fortune to "die" on the only real hill and he had a cardiologist riding behind him. The doctor kept him alive until the paramedics came and shocked him with the paddles.

He was told in no uncertain terms that had it happened anywhere else on the course he was history. He literally was dead when the doctor started to work on him. Reason...blocked arteries.

That is just one of many stories. I could relate the one of the corpse I passed in a 1/2 marathon or the amateur middle age boxer who ran 5 miles every day and how they found him in rigor in the shower.

I would think everyone has similar stories. Every procedure carries a risk but then so does cycling.

I've known a number of people who have either had the stent or open heart or both. They universally say the same thing when they recover...I've never felt as good. If they are blocked it happens gradually and you don't realize the change...just aging one usually thinks.

If my doctor called and recommended one based on just my family history I'd be there ASAP. I actually would like more done in terms of it based on history but the insurance needs "more of a reason."

The key...the doctor and the hospital. Pick both very carefully. Those odds you gave can vary greatly. Not all doctors are a Lance some are the "red lantern."

[Larry]

I have had my episodes with the heart.
I was taking Toprol XL, which I believe caused anxiety attacks. Blood pressure was running moderately high, and the BP monitor became my best friend. I was a mess! I stopped taking it.

In late February I did a Nuclear Stress Test and the result was not promising.
A blockage was detected, when my heart rate was high. I was concerned, but did not panic. The cardiologist said that I could have a heart attack. The Nuclear test has a 10 per cent margin of error.

Next step- Heart Cath., the Gold Standard. I did not hesitate. It would seem to me that you have to trust your doctors......they deal with this type of problem every day. So, they performed this procedure, and there was no blockage detected at all. I came away free of any heart problem. The Nuclear Test was wrong.

In the meantime, I dropped 15 pounds, and BP is now lower 120/78.

I encourage you to get another opinion if it will help settle you down. Please do not ignore the issue. If there is a blockage, it must be treated.

FYI......my 75 year old wonderful Mother had a triple by-pass performed
10 weeks ago. She is doing fine!

Sandy and his brother have good comments and knowledge. Thanks guys!

Larry in Dallas

[stackie]

You're right, that 0.2% mort rate sounds high. I did a quick google search and found a hospital advertising a 0.05% mortality rate for caths, much more realistic. Perhaps, your doctor said 0.2% morbidity (complications) and mortality rate. BTW, there is an estimated 1 in 50,000 chance that you will get into a serious automobile accident the next time you drive. Do you want to take that chance?

As previously stated, people with heart disease die. They die cycling, they die sleeping, they die on monday morning getting stressed at work... they also die on the cath lab table. If you've got lesions in your coronaries, sure there is some risk poking a wire around in those arteries. But, there's risk that they might clot while you're drinking that cup of coffee when you should have been laying on the cath lab table.

As previously mentioned, cath is the gold standard. Don't be a luddite, make use of the technology that is available to take the best care of your body that you can. Sticking your head in the sand isn't going to make it go away. Get a second opinion if you don't trust the cardiologist.

I'm going to leave you with one last euphemism. Denial is actually a symptom of heart disease.

Jon

The fine print. I am a doctor, not a cardiologist, and what I have said is purely my advice as a knowledgeable layperson. It would be impossible to make a valid medical opinion on your case without a complete history and physical. Therefore, do not construe anything that I have said as formal medical opinion or advice.

[CalfeeFly]

By the way don't forget Dr. Edmund Burke...he was the guru of heart rate training...he died in the saddle on a ride in Colorado. He was the editor and partial author of Precision Heart Rate Training which had a great deal to do with this training method becoming so popular.

It seems that Dr. Burke did not know of his arteries being blocked. He was riding with a group and they noticed at one point he wasn't there any longer. When they went back to look he was quite dead.

The morbid folks with an equally morbid curiosity could not help but wonder what his heart rate monitor did just before the fatal heart attack. Like many folks it was one massive heart attack and that was it.

Those with a better memory than mine...wasn't Jim Fixx the guru of running that got everyone "jogging" wasn't his early death an artery clogged induced heart attack? I believe it was. :confused:

[vaxn8r]

In this case the angiogram is the gold standard. It'll show you exactly what you need to know. The CT will not be nearly as clear, depends on someone really experienced in reading them (this is a bigger deal than you think) and will leave you wondering if they missed something.

I would not exercise at all until I got a definitive answer. Doesn't matter how good of shappe you are in. Your EKG showed ischemic changes on the tread mill. You're at risk right now. If you focus only on the risk and not on the benifit you'll be paralyzed with indecision. In my view the real risk is doing nothing.

A guy on our team had a MI last year while out on a ride. He's in great shape too. Fortunately he had it in town. He was off his bike draped over his top tube, someone stopped and asked if he needed help, he said yes and they drove him the the hospital. He had a triple bypass the next day. He's now back on his bike and stronger than before (which makes sense).

[CalfeeFly]

I did a google on Jim and here is part of what I found...

James F. Fixx authored The Complete Book of Running, at the time of its publication in 1977 the best-selling non-fiction hardcover book ever. The book's bright red cover featured Fixx's own running legs. The Complete Book of Running, still in print, eventually sold a million copies, both benefiting from and helping to launch the running boom.

Writing from personal experience, Fixx trumpeted the health benefits of running. After starting to jog at age 35, he quit smoking and shed 50 pounds. Yet at age 52, Fixx collapsed while running on a tree-shaded road in Vermont. He was found lying beside the road, dead of a heart attack. The date was July 20, 1984.

He might have lived longer had he listened to Dr. Cooper, who urged him to take a stress test during one visit to the Cooper Clinic in Dallas. Despite having cholesterol levels above 250, Fixx demurred for reasons we can only guess at. In the several months before his death, Fixx ignored what hindsight reveals were the warning signs of advanced coronary artery disease. An autopsy revealed blockage in Fixx's three main arteries of 95 percent, 85 percent and 50 percent.

[Louis]

Changing the subject just a bit, (since all this talk about keeling over has me thinking).

Should everyone go out and have a cholesterol (or any other type) test? I'll be 43 at the end of June and I've never had any sort of comprehensive "check-up" that could predict anything. Other than BP (somewhat elevated) and weight when I go to the primary care Doc, I have no clue what's going on inside my body. Is it worth checking, or do I just wait until something goes haywire?

I'm certainly leery of those "full body scan" things, and there's no way I would consider doing that, but I figure there may be a happy medium that involves some sort of health assessment.

Louis

[gasman]

I did a google on Jim and here is part of what I found...

James F. Fixx authored The Complete Book of Running, at the time of its publication in 1977 the best-selling non-fiction hardcover book ever. The book's bright red cover featured Fixx's own running legs. The Complete Book of Running, still in print, eventually sold a million copies, both benefiting from and helping to launch the running boom.

Writing from personal experience, Fixx trumpeted the health benefits of running. After starting to jog at age 35, he quit smoking and shed 50 pounds. Yet at age 52, Fixx collapsed while running on a tree-shaded road in Vermont. He was found lying beside the road, dead of a heart attack. The date was July 20, 1984.

He might have lived longer had he listened to Dr. Cooper, who urged him to take a stress test during one visit to the Cooper Clinic in Dallas. Despite having cholesterol levels above 250, Fixx demurred for reasons we can only guess at. In the several months before his death, Fixx ignored what hindsight reveals were the warning signs of advanced coronary artery disease. An autopsy revealed blockage in Fixx's three main arteries of 95 percent, 85 percent and 50 percent.

His symptoms were friggin chest tightness when he ran !!! He ignored the advice to go see a doctor and be diagnosed properly.

Go get a second opinion but do go see someone. Your risk of having problems with a cardiac cath are clearly lower than 0.2% since you are young and fit. The typical cardiac cath patient is a lot older and a lot less fit. If possible have someone who does a lot of catherizations,say over 500 per year.Also ask them if they use a drug eluting stent (they probably will) as the long term patency is much higher. Finally, we have one cardiologist here who does all his cardiac caths through the wrist, rather than the groin, and his patients do great ! Very cool.

[Sandy]

Thanks. My brother has the knowledge and gives good comments. I am simply related to him.

Sandy in Rockville

[Kevan]

Sometimes.. I can be such a stinker.

Sorry Sans!

[Sandy]

That is a heartless comment. :rolleyes:

Sandy

[TimB]

Louis -

Not that it means anything in particular, but at my place of employment they offer a free physical bi-annually for any employee over 40. I'd definitely suggest you get a comprehensive physical, including lab work for cholesterol, diabetes, prostate exam...and if there is any history of colo-rectal cancer, get a colonoscopy too. Sure, it's inconvenient and all that, but being dead is lot worse.

I recall reading something a few years back that men are very negligent in routine medical exams...

See http://www.menshealth.com/health2/prostate_maint_plan.html

My $0.02

[Jeff N.]

If you've gone through all the work-up and they've determined you have cardiac ischemia secondary to a blocked, or partially blocked, coronary artery, you should have the angioplasty and subsequent stent placement. People do quite well with this procedure, especially a heathy guy your age. Yes, going through something like this is scary. HECK yes. But this is your heart, man. Don,t fool around. Jeff N.

[Dekonick]

Whatever you do:

MAKE sure your cardiologist is
1) experienced
and
2) the hospital that does the angiplasty also has BYPASS. If when theyy do the cardiac cath, they find a lil more than expected (or things go badly which is rare) they can take you right to an OR and fix the problem.

Good luck!

Best results occur with HIGH VOLUME hospitals. The more they do it, the better they are (hospital, staff, rehab, the whole shebang!)

If you havent started yet - start taking 81mg asprin daily (ask your doctor first if its ok, but I am sure he or she would ok this unless you had some contraindication...)

Gotta run -
:D

[OnceFast]

Dekonick is right - choose your hospital and doctor wisely even if that means you have to travel. I would get the EBCT scan done first and I would go to a facility that has one of the new 64 slice machines. This will give you an idea of how many blockages you have and where they are. The fact that you have chest pain and ischemia pretty much means you have a blockage(s). This is important because as the number of blockages increases the stent vs. by-pass decision gets more important and you may not want to make that decision in the hospital. If you get an angiogram, get it done through the arm. I had a guy next to me when I had mine done who couldn't pee after the procedure and they were going to catheterize him to empty his bladder before before they would discharge him - ouch! Also, I could ride the next day - which I shouldn't have done. They dope you up for the procedure so that there is no pain, only a feeling of warmth when they shoot the dye through.

If you love riding and want to continue doing it you're going to have to risk doing something. As this board all to often reminds us, every time we go out on the road we take a risk.

Good luck.

[Desibhai]

Let me give you my personal experience. I had heart attack when I was 37 a serious one, I had to be revived using the paddles. Following that, they put a stent in (one only). I had only one artery blocked. I am assuming that you are taking Statins for controling your cholesterol. If not I recommend that you talk to your clinician and get on one. Also have your homocystein checked.

The way I see it, you are at a higher risk with doing nothing versus at least undergoing a non invasive procedure such as CT. Following that, If you have a block, get a stent (do get a second opinion, I am no clinician, but I can bet thatout 99.9% cardiologist will recommend that you undergo the procedure ASAP if you have a block). Because, just in case you have a heart attack, the damage is permanent and more harmful than getting an angioplasty (you may live through the heart attack if its mild or if you reach the hospital on time).

I am sorry to put this bluntly. I am lucky to be alive to see my son grow. He was 6 when I had my near death experience. I can't even imagine what my wife went through when I had my cardiac arrest (she was in the ER with me at that time). I have, since then been biking, l do have to watch my heart rate and take the necessary medications and maintain healthy eating habits. I hope to live to my 80's. Remember, you can get killed crossing a road. There is always a risk in any invasive procedure, including something as simple as taking your wisdom teeth out.

[Skrawny]

I am also an Internist.
If you have symptoms and an early positive stress test, then your mortality risk of NOT having the procedure is already higher than the risk of the procedure. If they find a blockage, then they will do an angioplasty and stent or -worst case- a bypass surgery (if there are three blockages, a blockage in the main artery, or one that is technically difficult to stent). Folate therapy has been shown to decrease the rate of stent restenosis (closure) after the procedure. Remember that a positive stress test or symptoms usually means that there is more than a 40% narrowing in an artery. The majority of fatal heart attacks occur in arteries that are 40% narrowed (because they are the most common). If your symptoms and results are from a narrowed artery, you have been given a warning that not everyone gets. There is no need for an EBCT, because the results are already worrysome enough to necessitate a catheterization, it wouldn't help or effect the diagnosis.

Regarding cholesterol, all people older than 30 should have their cholesterol checked.
-s

[weisan]

cycleheart-pal, thanks for initiating a discussion on a topic of such importance here at the forum. It shows how much you valued the opinions of the people here and judging by the response, they, in turn IMO, have not let you down. I hope you felt the same way.

I would like to chime in from a slightly different angle. It's about my dad. My dad had a heart attack four years ago at the age of 65. He survived the ordeal and has since gone through angioplasty with a stent inserted. He has two main ateries blockage, one at 70% and the other at 40%. After the operation, his heart is functioning at 55% normal capacity. And forgive me if I am quoting medical terms incorrectly because I am not trained in that area and is speaking based on my own understanding of the situation. That experience changed him dramatically. He has changed his lifestyle and diet to better suit his energy level and heart condition. He watched what he eats more carefully -- not that he has been wantonly irresponsible in the past like eating fast/fried food everyday but the doctor told him that the blockage was accumulated over the course of 30+ years through normal "intermittent indulgence" into the fatty/creamy/salty food, which we ALL do sometimes. That serves as a caution to me because right now I am where things start to go downhill for him, around 35+ yrs-old. To his credit, by today's standards (subjective), I won't even consider his previous-day diet as excessive. It's probably indicative of 80-90% of the general population, and that's just my guess, not backed by any scientific evidence. He exercised regularly. In fact, growing up he would bring me along to play badminton three times a week. For those who are familiar with the game of badminton, it's intense workout involving lots of speed spurts and body agility. In other words, in my mind, it's a "complete" workout that trains both the lower and upper body, plus the cardiovascular component of it. Despite having an active lifestyle throughout most of his life, my dad has a couple of "minuses" going against him -- high blood pressure & high cholestrol, hereditary heart disease runs in the family. My grandfather died of a stroke.

The main point I was trying to make here was that I am thankful for my dad's decision to go along with the doctor's recommendation in having angioplasty done on him. Actually he has no choice, death warrant was already served at his doorstep when he had to make that decision. He is still here with us, witnessing the growth of the extended family, providing me with the benefit of his experience and wisdom, and most of all, allowing me to love him the way he has loved me and took care of me. That meant alot to me. The circumstances surrounding his heart attack is most unusual. My younger brother was getting married and I had brought the whole family home to Singapore for a reunion and attend the wedding. It was the first time in about six years that everyone came back together as a family. My brother lives in Australia with his wife. Obviously, the wedding on top of the family reunion was an exceedingly happy occasion for my dad. In fact, he was so roused up that I believe till this day, it was the excitement (and stress) that brought forth the heart attack. Here's the part that scares me even now when I think of it. When we were there, everything was fine. We left and took a plane back to the States. About 15 minutes after we touched down in Austin and walked into the house, our phone rang and my mum was on the other line telling me right at that moment how my dad was lying on his bed, hard of breathing, and sweating profusely -- the heart attack in progress, a dying man. She was relatively calm and handled the situation well. (she's a strong woman :D, always said, if not because of the children, she wouldn't have stayed at home and would go on to become a CEO of a big corporation. Yeah right, mum!)

Anyway, so my dad was dying there in front of me (I mean, on the phone) For the next 4-6 hours, it was a nail-bitting experience. The ambulance came quickly and rendered immediate treatment. We were told if not for early detection and fast response, my dad would surely die. In that short span of time, he has already lost 50~70% capacity of his heart function. The aftermath X-ray shows a lot of scarred tissues around the heart. From my layman point of view, it looks a lot like a couple of "dried up river tributaries" running through the heart.

Anyway, I am sure my description of the entire situation is flawed with medical inaccuracies but really my main point was....Cycleheart-pal, I hope for the sake of your loved ones, you would make the right choice.

Take care of yourself, buddy. Do stick around, post more often, it's good for the heart. ;)

weisan

[cycleheart05]

Dear Forum members,

Thank you for all the replies. I'm sorry I was unable to respond. Soon after I posted I experienced another incident. I felt increasing pressure in my chest and after several hours I was so scared I went to the hospital. The doctors recommended I check myself into the emergency room and to have an angiogram peformed immediately. I no longer had a choice. The gun was at my temple and I had to pull the trigger.

I wish I could report that I faced my own mortality with better aplomb but that was not the case. When I was told I needed to check into the emergency room a feeling of dread engulfed me as I tried to come to grips with everything that was happening. When the nurses loaded me into a wheel chair and hooked me up to an oxygen cannister for the trip to the emergency room I was overwhelmed and I broke into tears. I managed to compose myself by the time the nurses wheeled me into the emergency room but when the attendant who was checking me in asked me for my next of kin my voice cracked and I couldn't speak as the tears streamed down my face.

After I checked into the emergency room the doctors hooked me up to several machines. That's when my whole body started quivering and shaking uncontrollably. The nurses asked me if I was cold but I told them I was shaking because I was afraid. The nurses proceeded to do a blood test to see if there was any indication of a heart attack. They did an ekg to measure my heart rythm. They inserted a catheter into my arm and pumped blood thinners into by blood stream to prevent clotting in my arteries. They gave me nitrogliceryn to dialate my blood vessels in order to increase the blood flow to my heart and they gave me oxygen to increase the oxygen content of the blood that was reaching my heart. They took chest xrays. After several hours and three doses of nitro the doctors and nurses successfully got the pressure in my chest to subside. In the meantime I got the shaking down to one leg. My cardiologist came to see me and he asked me some questions. Because I was feeling more pressure in my chest while lying flat on my back than while sitting up he thought there was a chance there might be some fluid in the sack surrounding my heart which was causing the pressure I was feeling in my chest. If that was the case I could avoid having an angiogram. He scheduled an echo cardiogram which involved an ultrasound of my heart for the next morning followed by an angiogram if needed.

I was sent to the cardiac ward of the hospital until the heart ultrasound and an angiogram could be performed. On the cardiac ward they closely monitored my heart rate and vital signs and I had a nitro patch on my chest that continually dosed me with nitrogliceryn throughout the night. All the rooms on the cardiac ward had large open doorways to a common hallway that enabled the attendants to wheel gurneys in and out and which the nurses and doctors used to quickly enter and exit the rooms. I could hear the other patients around me as they talked to their doctors or nurses and they could hear me. I felt a commarderie with the other patients whose voices I could hear and I admired the strength they seemed to possess as they faced the prospects of serious surgeries.

After a few hours of sleep with unfamiliar hospital noises intermittently jolting me awake a nurse came around in the middle of the night to take everyone's blood. As I sat up in bed to give blood I started feeling light headed and I labored to breathe. In response other nurses came rushing in and ripped the nitro patch off my chest and hooked me up to an iv and examined my blood pressure. After a short time my blood pressure rose to more normal levels and the nurses decided to closely monitor my blood pressure the rest of the night. They put a blood pressure cuff on my arm which was hooked up to a machine that automatically inflated the cuff every twenty minutes and took my blood pressure. The cuff inflated everytime I was drifting off to asleep so I didn't get much rest and I had a headache from all the nitro.

In the morning a nurse wheeled an echo cardiogram machine into my room to perform the ultrasound on my heart. For the rest of the morning I waited for the results. The nurses determined I was stable enough to remove the blood pressure cuff so I spent the morning and early afternoon drifting peacefully in and out of sleep. Later in the afternoon my cardiologist came in and told me the echocardiogram was negative and it was time to perform the angiogram to find out what was wrong. I assented and then I broke into a sweat as the fear started welling up inside me.

A few minutes later the angiogram team arrived to prep me for the procedure. I was told to lift my gown so they could shave me. The nurses relieved the tension and my embarassment by cracking jokes. When the nurses were done shaving me they wheeled me down to the operating room. As we glided through the hospital's corridors I tried to go over the potential decisions I might face. During an angiogram they don't put you under they sedate you. Depending on what the angiogram revealed I was going to have to make critical decisions on how to proceed. If I only needed a single stent my choice was clearcut I would have it inserted. If I needed multiple stents I wasn't sure what I wanted done. If I needed bypass surgery I would probably have a few days to decide whether or not to proceed with that. If I needed emergency bypass surgery then it was in the doctors hands.

We arrived at the angiogram operating room and the nurses started their preparations. After a short while they donned radiation suits. An angiogram involves inserting a tube in your groin and sliding it up to your heart to inject dye into the coronary arteries while a machine displays images of the arteries. The machine that takes the images shoots radiation through the patient's chest and the doctors have to protect themselves from the radiation. To protect themselves the doctors and nurses donned black suits with lead in them and strapped them tightly around their chests. They also fastened black lead collars around their throats to protect their thyroids from the radiation. To protect their eyes and head they had a large lead impregnated glass shield with a sickly yellowish tint that they positioned over me. As thier preparations proceeded I got more and more nervous. Finally they were ready and the nurse sedated me by injecting something into my iv while they waited for my cardiologist to arrive. The nurse asked me if I felt anything and I said no. She injected some more drugs into the iv and she asked me again how I felt. Once again I told her I didn't feel anything. She injected more drugs. The rest is a blur.

I dreamed a dream. A wonderful dream. In my dream there was nothing wrong with me. I was healthy and my heart was fine. But I woke up from my dream in the cardiac ward. The reality of the situation intruded on my wonderful dream and abruptly shattered it like a bottle hurled against a concrete sidewalk. I was in the cardiac ward of a hospital because I had heart problems. My thoughts drifted lazily in and out of a state of half consciousness. Had I dozed off while I was waiting for the angiogram team to arrive and take me to the operating room? I lazily remembered the black radiation suits. There was something vaguely confusing about it all. Images of a cluster of veins and arteries with what looked like a bent coat hanger in them drifted by my mind's eye. The doctors clad in their black radiation suits floated by again. I didn't want to wake up. It was so peaceful in my dream. I wanted to stay there.

I was awake. What happened? I couldn't sort it out. I had a throbbing pain in my right hip. The doctors had performed the angiogram. I was alive. A nurse came into my room. What happened I asked? What had the doctors done to me? The nurse hurried out again to find out. A few minutes later the nurse came back in and gave me the news. My coronary arteries were clear. There were no blockages. There weren't even any signs of build up anywhere. My arteries were pristine. A dream come true. They had put me to sleep after the angiogram and a side effect was the amnesia.

They realeased me several hours later and now I'm at home again. There are still questions. Why did I fail the stress test? Why were several ekg's abnormal? Why did I have two incidents where I felt pressure in my chest? My cardiologist thinks it's possible I have an inflammation of the heart lining which didn't produce fluid that the echo cardiogam could pick up. He prescribed Motrin for a few weeks. I have to relax and take it easy for a few days so the hole in the front of my hip can heal. After that I can slowly start exercising again. I have an appointment to see my cardiologist again in a few weeks. I'm alive and relatively healthy.

I can't wait to ride my Serotta.

[cycleheart05]

In conclusion my thoughts about my experience are varied. I spent hours staring out my hospital window looking at the blue sky and green trees and wondering if I would ever see another sunset. Today the sky seems a touch bluer and the trees are a more vivid green and I got to see another sunset. I suggest you not take your health for granted. I would recommend that anyone who is interested in their overall health should take a look at Dr. Dean Ornish's book on heart disease and read just the forward and the chapter on diet. If you don't want to spend the $15, I'm sure your local library has the book. If your interest is piqued you can explore other parts of the the book. The message he delivers is simple. Saturated fat in your diet is bad for you. If you don't watch it you will end up with blocked arteries. My experience indicates you don't ever want to hear your doctor tell you that you have heart disease. If you are informed then at least you will be making a conscious choice about your diet and health. I thought I was very careful about what I ate but I was ignorant and I took my health for granted because I exercised a lot.

The big revelation in the book is a clinical study Dr. Ornish conducted that showed that a diet devoid of all saturated fat could actually reverse heart disease. In other words it could reduce blockage in coronary arteries. He followed two groups for one year. The study group ate a diet with zero saturated fat as well as ceased smoking and drinking and went to support groups and counseling to reduce stress in their lives. The control group followed government guidlines for a low fat diet. In as little as a month members of the study group got rid of crippling chest pain and angina that prevented some of them from working. At the end of one year, 85% of the participants in the study group had better blood flow to their hearts and drastic improvements in their cholesterol levels while the control group stayed the same or had more blockage and worse heart disease. The results were so shocking that Dr. Ornish immediately got funding for another 4 years. The one year results were picked up by the major news media and hailed as a breakthrough in the treatment of heart disease. At the end of five years, Dr. Ornish published the percent reduction in blockage of the coronary arteries as determined by angiograms and he documented the increased blood flow to the study groups' hearts with something called a PET scan. The study ended in 1995.

I asked nurses at the hospital about the book. None had heard of it, and all of them were skeptical. How they asked can you reverse blockage short of going in and scraping it off or compressing it with angioplasty and putting a stent in? I haven't read the whole book so I don't know what the mechanism was that removed the plaque. I'm not at all sure Dr. Ornish knows. I read some reviews of the book at www.amazon.com and several reviewers slammed the study. My cardiologist is the one who mentioned Dr. Ornish's name when we were discussing the various risks I was facing and the alternatives to not doing an angiogram and that is why I purchased the book. I also bought a book called the Mayo Clinic Heart Book and in that book they mention the positive results of Dr. Ornish's clinical study. All I know is I plan on following Dr. Ornish's zero saturated fat diet in an attempt to lower my cholesteral so I can get off the cholesterol drugs I'm currently taking.

I post this in the hopes that my experience might provide valuable information for somebody else.

[weisan]

cycleheart-pal, thank you for giving us such a vivid inside look into what you have experienced in the past few days. The information you provided is P-R-I-C-E-L-E-S-S. I am moved to tears by your courage and humility. Thank you.

May the Peace of Christ Be Always With You.
weisan

[Birddog]

Thankyou, that's one well written commentary. Some (probably obscure) Comp 101 instructor deserves a big thankyou too.

Birddog

[CalfeeFly]

Since the arteries are nice and clean...(the procedure now that it is done...similar to Roto Rooter) I'd not discount stress. How's work? It seems to be driving everyone to the edge these days. :crap: :argue: :no: :confused: :butt: :help: :mad: :(

Happy riding! :bike: :hello:

[Sandy]

It sure is well written. Extremely well written. Great flow of words. It describes an emotional event in a very natural manner, depicting so well the feelings of the events as they unfolded. Great job in describing a tough personal event. Superb, in my humble opinion.

I hope to read many more posts from cycleheart05.

From the heart,

Sandy

[Lost Weekend]

That was a very intense read. I broke out into a cold sweat myself imagining what you were describing. Thanks for sharing.

[Skrawny]

Thank you for sharing your experience. Thank God that the angiogram was negative. :banana:
-s

[Ginger]

cycleheart,

Sometimes it is best if the decision is taken out of our own hands.

Good luck with making the changes to your lifestyle that you envision. It is difficult.


Glad to see you typing to us after your ordeal.
Mary Ann

[bostondrunk]

Congrats bro.
Did they check you for Hiatus Hernia (sp?) as a possible cause for the chest pain?

[Tom]

Isn't it great to get news like that? You're fearing the worst and they tell you the best. There's a lot of good things you'll feel in your time and that one's right up there with all of them. Thank you for writing that because you really made my day, you did.

As far as reversal goes, my uncle's in his eighties and they told him he'd need surgery because he had some but not a lot of blockage. They said it wasn't dire but needed attention. He told them to look again in six months and if he had the same blockage to go for it. He went home and started eating oatmeal like there was no tomorrow. He went back and things had cleared to the point that they aren't thinking surgery any more.

But that's my uncle. Last summer he dragged his old canoe out of the garage (a giant aluminum Grumman) and the mast, downriggers and rudder he built lo these many years ago. He took it up to Sacandaga, rigged up and put in. As he told me, "I started noticing whitecaps." He was bombing around the lake and then he realized he had no idea where his pal's camp was. "It's all just a damn green wall when you're out there on the water." So he did the only logical thing. He saw somebody's beach, pointed the canoe at it and yelled "Ramming speed!" He beached himself about 20 feet up their lawn, went in and asked to use their phone.

He drives his son crazy. I think it's a hoot.

[Spinsistah]

One of my good friends I cycle with had a stint put in about 4 weeks ago - he rides an old, heavy steel Schwinn and can outrun anyone on it. He's probably 60 years old.

Another good friend, who turned 34 today, lost his dad two weeks ago to a massive heart attack. His dad was only 55 and other than the heart issue, in very good health.

You can be the guy that outrides everyone at 60, or the guy that doesn't make it past 55. I'd take the chance and go ahead with the procedure. As it stands now, things might get a whole lot worse.

JMHO.

Steph, aka Serotta Spinsistah, Sharing Shih Tzus and Kevan with Serotta Sandy (what a mouth full)

DIDN'T READ FAR ENOUGH - I'm so glad you're okay.

[vaxn8r]

Am I the only one who feels his chain was yanked?

Oh yeah, where can I buy that book?

[Andreu]

Amazing story.
It reads just like a chapter out of a book.
A

PS
Regarding cholesterol
Eat oats they keep the cholesterol down...or more specifically the oat beta glucans in the oats keep the cholsterol down.

[cycleheart05]

Sorry I didn't come here to sell a book. I came here because I was desperately seeking information about heart disease so I could assess my risks. The book is out there. My cardiologist mentioned the book when we were discussing alternatives and when The Mayo Clinic Heart Book also mentioned the positive results of the clinical trial it was something I had to consider and investigate. I found it disconcerting that the obviously well educated head nurses and doctors in the cardiac ward didn't even know about the book. If the clinical trial was flawed the medical profession should be prepared to tell their patients why it is bunk. It was not an inconsequential clinical trial with ambiguous results. The results made headline news in the major news media and it was hailed as a revolution in the treatment of heart disease.

I was also cognizant of the fact that the medical profession is in the business of selling expensive medical care and private hospitals are in the business of making money. I can only imagine the tremendous pressure a cardiology group is under to cover their overhead as well as generate profits for their employer and earn high enough salaries for themselves so that all the sacrifices they make are worthwhile. Today a hospital not only has to compete with other hospitals in the same city for patients but also with other hospitals nationwide and sometimes even hospitals world wide with the spread of medical tourism. There are now beautiful brand new five star hospital/hotels with all the latest medical equipment in the middle of Indian slums with expert staff and maybe even expert doctors that charge a fraction of what western nations charge for medical procedures. I had to consider whether a doctor's medical advice may be skewed by those competitive forces. Luckily I found a cardiologist who was willing to discuss the alternatives and give me what I considered to be a remarkably unbiased survey of my choices and some of the associated risks.

Everyone has to draw their own conclusions and try to make informed decisions about their own health. I appreciate all the advice proffered by so many people. I'm not sure whether the roller coaster I've been riding on is coming to another big drop off or if this is where I get off but at the moment I'm apparently healthy and free of serious heart disease. I still have high cholesterol and I don't want to be on cholesterol drugs the rest of my life. I'm exploring alternatives.

[Andreu]

the line
"I found it disconcerting that the obviously well educated head nurses and doctors in the cardiac ward didn't even know about the book".
does not surprise me at all.

My experience of the medical profession in Europe is that, as a patient, you should always read around and, if possible, get a second opinion.

These guys are highly educated but often in high pressure jobs with little time to "read around" the subjects and there is a tendency to follow "standard practices".

As we know everybody is different.

Cholesterol is(was) kind of my job for a while (when I worked in the food industry). Oat beta glucans (OBGs) are available commercially here...the problem with oats is they contain less than 5% of OBGs (can't remember the exact % - but it is low) so to get the required effective dose it means you have to O.D on oats a little bit. There is pure oat beta glucan over in Europe (in powder form) which is great for adding to recipes (biscuit and cake mixtures, cereals etc). Not sure about the US market. There are also plant sterols which are available and are added to yogurts and margerines etc. The problem with the plant sterols is that they are very expensive and you are basically in the hands of the big food companies as far as choice goes and how you deliver to your system - they also work in a slightly different way in the body (http://ific.org/publications/factsheets/sterolfs.cfm). I prefer the oat/beta glucan route because it fits in with cycling as far as complex carbo and Glycemic index goes and I get the choice when I eat it and what I add it too. There is some data to suggest that OBGs are biotic and can have a immunological effect (i.e. help with natural bacteria in the gut) too which is a bonus.
(http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/oat_0323.shtml)

Hope this helps and feel free to ask any questions on this as it is kind of my job and although not a medic I work closely with universities and researchers who work on this kind of stuff (heart disease, obesity, diabetes etc) at the "cutting edge" so to speak. I insist that overall balance has to be correct....eat when you are hungry, exercise correctly and eat a balanced diet. (containing fruit and veg). This is an extremely complicated area biochemically and there are many things still not well understood. There is significant amount of fundamental research taking place which will help us understand and control chronic diseases in the future.

I still think your story is incredible ...maybe with your writing style you should write a book!
A
Good luck!
:beer:

[OnceFast]

I got the same feeling as vaxn8r - hope I'm wrong.

[vaxn8r]

Sorry I didn't come here to sell a book.
You didn't? You sure seem to be pushing it. How many links did you post?
If the clinical trial was flawed the medical profession should be prepared to tell their patients why it is bunk. It was not an inconsequential clinical trial with ambiguous results. The results made headline news in the major news media and it was hailed as a revolution in the treatment of heart disease.
Well that makes it for me. If the major news media hailed it as a medical revolution I'll be all over that. How much does your book cost again?
I was also cognizant of the fact that the medical profession is in the business of selling expensive medical care and private hospitals are in the business of making money.
Seems the one doing the selling, as well as wasting expensive medical resources, is you. Buddy, you need a psychiatrist not a cardiologist.

[Jeff N.]

So what was it, man? Pericarditis? Endocarditis? Jeff N.

[OnceFast]

I guess what makes me skeptical about this is that someone who just finds out he(she?) might have heart disease would turn to a forum full of strangers rather than to friends and known associates that might have similiar knowledge. If someone with thousands of posts like BumblebeeDave posted with this it would be entirely believable - but this is starting to smell funny.

[ajs122]

I highly recommend Russell L. Blaylock M.D.'s book, Health and Nutrition Secrets that can save your life. Since I've been on a non-fat diet in about 6 months I have reduced my aginia, increased my strength and vigor, and I'm breathing much better and dropped 8 lbs and my BP is a rock solid 116/67 at age 62. I take fish oil with each meal, Q-10,eat lots of fresh fruits and vegtables and very little meat.I make sure whatever I eat has no MSG, no hydrgeated oil. Its important your SO is also on the same diet, my wife has dropped 25 lbs. She cooks with extra virgin olive oil, there is no butter in our house.This is not an extreme diet but its a hell of a lot smarter diet.

Basically what Blaylock is saying that there is an epinemic of heart disaese and cancer in the last 100 years ever since our society has gone to processed foods. I believe I'm on the way to reversing my heart problems and everyone should examine their diet carefully. You'll be glad you did.

[gasman]

Cycleheart- I have seen this before. A patient will have a positive stress test and a normal angiogram. There can be a lot of reasons. Did your cardiologist mention coronary spasm ? This is the result of just what it sounds like, one coronary artery will spasm and decrease the blood flow to the heart enough to cause ischemia. It can be demonstrated angiographically but it is difficult to do so.
As drunk mentioned a hiatal hernia can also cause chest pain symptoms. Esophageal spasm can also cause chest pain that is relieved with nitroglycerin.
Rarely gallbladder problems will be thought to be cardiac in origin.

I read Ornish's studies a number of years ago and they seem to be well done with impressive results. The problem in the real world is that almost nobody can maintain the Ornish diet for any length of time ie. at one year less than 5% will still be on it. The diet is not very palatable because of the very low amount of fat allowed. I think you have to be very motivated or be a monk to stick with it.

Not all fats are bad. Some are good and even necessary. I try to maintain a happy medium by avoiding hydrogenated fats in foods . These trans fats are in many processed foods but the epidemiology points to them being bad actors in vascular and heart disease.

Now cycleheart may be trying to sell Ornish's book but I choose to take him at face value. This is a small forum of only a couple thousand participants of which only a few hundred read regularly. Hardly nationwide coverage reaching tens of thousands.

[KirkKaas]

In July of 04 I had many of the symptoms that you described. Unlike you I had been ignoring them for over 6 months. Finally I decided to go to the Doc.
They found through an agioplasty (after I had flunked several other tests) that I had an 80% blockage in my left desending cornary artery. They were surprised that given the level of my training, I am an ironman participant, that i had not had a heart attack already. Three day later I had an angioplasty with a medicated stent, one night in the hospital and I was home, five days later I was swimming, 10 weeks later I ran the seattle marathon. I have been happy and healthy since. Remember that the statistics take into consideration all patients. What would they be if cardiac surgeons only worked on healthy, fit people who scheduled there procedures? I decided I would rather take my chances at Virginia Mason than at pool, a woodsy trail or in the middle of a group of cyclists. Goos luck with your decision but having the procedure was a godsend for me.

Kirk

[weisan]

Now cycleheart may be trying to sell Ornish's book but I choose to take him at face value. This is a small forum of only a couple thousand participants of which only a few hundred read regularly. Hardly nationwide coverage reaching tens of thousands.

Gas-pal is a wonderfully generous and patient man. He reserves his judgment till later....what's the hurry? :D

[shaq-d]

hm, came late. thanks for the posts cycleheart, interesting story.

my dad had an angio and never recovered after the surgery, dying soon after. so that's the other side of the coin.

in other news, i am utterly unsurprised that the human body can heal itself when you treat it right. it was built to do so.

i'd say you need to chill out/relax, take a vacation, and eat rite. you've obviously got the exercising stuff down already.

sd

[Dekonick]

[QUOTE=gasman]Cycleheart- I have seen this before. A patient will have a positive stress test and a normal angiogram. There can be a lot of reasons. Did your cardiologist mention coronary spasm ? This is the result of just what it sounds like, one coronary artery will spasm and decrease the blood flow to the heart enough to cause ischemia. It can be demonstrated angiographically but it is difficult to do so.
As drunk mentioned a hiatal hernia can also cause chest pain symptoms. Esophageal spasm can also cause chest pain that is relieved with nitroglycerin.
Rarely gallbladder problems will be thought to be cardiac in origin.

I was thinking Prinz metals angina.

Hey - regardless if the story is real or not the advice given by the known forumites is sound (for the most part)

eat more fish! :D

[ClemmonsHoo]

I am 45, bike 100+ miles per week (well, 'did') at a pretty high level, and I'm in the best shape of my life since I was about 25. I was planning on doing a TT in October, and maybe even racing some next year. On July 21 (yep, 8 weeks ago), I was biking up a hill at a good clip (passing everyone) when out of nowhere - BOOM - I had a heart attack. Luckily I had some friends on hand to dial 911. To make a long story short, I had an MI that required immediate bypass surgery.

The cause of my heart attack was ultimately a myocardial bridge (MB) across my Left Anterior Descending (LAD) artery. 25% of the population may have this genetic condition, but few will be affected by it. In my case, I had no previous symptoms until my MB caused my LAD to dissect, blocking all blood flow to the bottom of my heart, and I found myself on the side of the road writhing in pain.

I never had a stress test, or physical, or anything like that because I seemed to be in great health and great shape. Heart problems were something that only happened to other people. Now that I know what I know, and now that I sit here with this 12" scar down the middle of my chest, not able to bike for God knows how long (while my friends go out everyday), I can honestly say, if your Doc sees trouble, please go get it checked out. I was told all of my life that I had a heart murmur and that it was nothing to worry about. In fact, I had a ticking time bomb in my chest that almost killed me.

[Larry]

In February I had a Nuclear Stress Test done. Results were positive, and it was determined that I could have a heart attack.
Next test.........Heart Catherization. Results...... "Your heart is fine." No blockage detected.

Nuclear test has a 10 per cent margin of error.

Since that time through exercise and a reasonable diet, I have dropped 15 pounds and BP is 120/75.

Long live the CSi! It is helping me to regain youthful vigor.

Thanks to Sandy and his brother for their comments and advice.

Larry in Dallas.

[Sandy]

In February I had a Nuclear Stress Test done. Results were positive, and it was determined that I could have a heart attack.
Next test.........Heart Catherization. Results...... "Your heart is fine." No blockage detected.

Nuclear test has a 10 per cent margin of error.

Since that time through exercise and a reasonable diet, I have dropped 15 pounds and BP is 120/75.

Long live the CSi! It is helping me to regain youthful vigor.

Thanks to Sandy and his brother for their comments and advice.

Larry in Dallas.


Juat wait until you get my brother's bill for consultation and my bill for contacting the consultant, and then you really will be sick!! :) :)


Heartless Sandy

[ada@prorider.or]

well i have my share of experince of people sporting on all kind of levels and testing and still get a heart attack or
brain attack
lots of people always did good time of healty living

what i still find amazing that very little people understand the level op potasium need in a body
in hardly any sport test there is an look on this
and while this can cause hart attack brain attacks
and death and when a person is died its hard to find the potasium level while it drops after death
so you should look at this
even when your healty
for people who had any attack its the best to keep the bloodpressure under 140 the the most uplevel
beneath the 100 downlevel is a absolute must
also you should in all time ´s keep a low cholestorol if you had a attack
research has found that 38 mg of ascal every day is the best but in usa they say 75 mg
do this !!
cees