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Cardiac worries (Read 1143 times)

JML


    The last couple of weeks have been a bit unsettling.  I have had both a former college roommate and a work colleague pass away suddenly due to heart attacks.  Both were in their early 40s and were in apparently good health.  Neither was especially active but they were definitely in the normal healthy weight range with good eating habits.  As someone who has been known to push myself (and my heart rate) pretty hard at the end of a race, my upcoming second attempt at the marathon in Chicago is taking on a new dimension.

     

    I already have my annual physical scheduled a month before the race and have approached my Doctor about performing some additional cardiac testing to make sure that there is absolutely nothing to be concerned about before I race for 26.2 miles.  He did perform an echocardiogram last year to rule out cardiomyopathy (heart muscle function) issues or valvular disease as I have an older sister who had a stroke that was caused by a hole between the two upper chambers of her heart.  The echo found nothing other than a slightly enlarged heart due to my running habit.  At that point, my Doctor (a former 2:40 marathoner) pronounced me healthy and sent me on my way.   Since then, I have cheerfully run for the last year until recent events have made me more concerned about heart health.

     

    As a result of my concern, my Doctor suggested performing a stress test to measure my heart health and make sure that I am healthy.  This seems like a sound approach but I was wondering if anyone here has any other perspectives.  I am absolutely going to heed my Doctor’s advice and guidance, but would like to know if there is any other testing that I should suggest/consider.

     

    Thanks in advance

     2014 goals: run a bunch....race some.....repeat...


    Fat butt on couch

      As a result of my concern, my Doctor suggested performing a stress test to measure my heart health and make sure that I am healthy.  This seems like a sound approach but I was wondering if anyone here has any other perspectives.  I am absolutely going to heed my Doctor’s advice and guidance, but would like to know if there is any other testing that I should suggest/consider.

       

      Thanks in advance

       

      Read this.

       

      And this.

       

      And this.

       

      The first two were done by an acquaintance of mine...tried to get on the study but the logistics were just too difficult.

       

      My non-medical opinion...

      -Life is dangerous.  None of us get out alive.  In other words, the risk of running is typically no greater than other activities (or lack thereof).  There is nothing that can give you a guarantee that nothing bad will happen.  Same as when you get in your car to drive to work, which is likely more risky.

      -Marathons can cause short-term changes in the heart.  Some of these are negative but resolve pretty quickly.  Running also does a lot of positive things for you that must be weighed in the equation.

      -Better training protects from them.  It is wiser to make sure you train appropriately for something as demanding as a marathon.

      -Bad weather (heat, dehydration) magnify the difficult of the event.  Take care of yourself if the weather is contrary.

      -Your doc's plan sounds reasonable.  Sure, you could demand an MRI, it will be expensive and not 100% conclusive either. 

      -The author of the study I posted above ran a marathon after doing that study.

      "If you want to be a bad a$s, then do what a bad a$s does.  There's your pep talk for today.  Go Run." -- Slo_Hand

       

        Trust your doctor (especially if he's a cardiologist). If there's the tiniest hint of a red flag, he's going to shut you down. They live to shut runners down. So if he gives you the good-to-go, you're good to go. I had my yearly cardio check-up this morning. With the enthusiastic encouragement of my cardiologist, I'm running longer and faster than I did before my heart attack three-and-a-half years ago. (Blocked artery due to a long-undiscovered birth defect.) Listen to your doc, take spaniel's good advice, and go pound some pavement. 

          You may also want to read this from the recent consumer reports magazine

            Sounds to me like you've already been over-tested. I did not think that echos were usually given without some sort of indication that there might be heart trouble (maybe something turned up on an EKG that suggested further testing, but you left this out of your account?)

             

            I could be wrong (I am not a doctor), but as I understand that an echocardiogram will pick up pretty much any problem that you might have.

             

            I know a little about these things because I passed out on a run once, had an abnormal EKG, then an echo.


            A Dance with Monkeys

              Sounds to me like you've already been over-tested. I did not think that echos were usually given without some sort of indication that there might be heart trouble

               

              Given the family history, the echo was reasonable.

               

               

              as I understand that an echocardiogram will pick up pretty much any problem that you might have.

               

              You are, in fact, wrong. An echo will only pick up large problems with the heart muscle, but will do almost nothing to identify abnormalities in the coronary arteries.  An echo + treadmill, however, can.

               

              An ECG in normal, healthy folks is a poor screening test, really, for anything.

               

              I think your doc's plan is reasonable.  That said, in absence of specific risk factors, your chances of having a falsely abnormal test is higher than finding a true abnormality.  Having friends who had early MIs is not a risk factor for you. And if we ran medical tests to screen everybody who suddenly had fear of a rare event striking them because it also struck a friend, the cost of healthcare would rise even faster and higher than it currently already is. So it is also reasonable not to do the test.

              R2E


              "run" "to" "eat"

                trent, i thought you said "falsey". near bout gave me a heart attack!

                i find the sunshine beckons me to open up the gate and dream and dream ~~robbie williams

                JML


                  Spaniel / YMMV - Thanks for the links.  Definitely food for thought which help me to be better informed when I see my doc.  While nothing in life is certain, I always feel that being informed makes for a better result in the Doctor - Patient relationship.  The fact that my Doctor is a marathoner and encourages questions is the reason that he is my trusted primary care physician.

                   

                  Jeff - The echo was given shortly after my sister suffered a stroke due to an easily repairable heart defect. Funny story (after the fact at least) - She was an incredibly unlikely stroke candidate (very active, basically vegetarian, non smoker, no alcohol, 100 lbs on a good day) so the local emergency room concluded that she was a suffering from a mental breakdown and put her in the psych ward for 48 hours.  Once my parents and I convinced them to take another look and do some bloodwork, they said whoops and transferred her to a better hospital where she thankfully began her recovery.  The defect was repaired shortly thereafter and she is doing great.  My Doctor said that he wanted to rule out the same defect in me and was also concerned about mitral valve prolapse in another sibling.....hence the echo.  The stress test may be slight overkill but I am more than a little rattled after watching two people in my life pass from heart attacks in rapid succession. 

                   2014 goals: run a bunch....race some.....repeat...


                  A Dance with Monkeys

                    being informed makes for a better result in the Doctor - Patient relationship

                     

                    yep

                      Ah--I missed the family history part. Doh! Shoulda read better.

                       

                      Thanks for sharing, JML.

                      R2E


                      "run" "to" "eat"

                        jeff, perhaps you need to work on your ability to pay attention.

                        i find the sunshine beckons me to open up the gate and dream and dream ~~robbie williams

                          jeff, perhaps you need to work on your ability to pay attention.

                           

                          Ahhh yes. Definitely. Ha ha.

                          JML


                            Ah--I missed the family history part. Doh! Shoulda read better.

                             

                            Thanks for sharing, JML.

                             

                             

                            No worries.  Thanks for your feedback.  I hope that I am just being overcautious.

                             2014 goals: run a bunch....race some.....repeat...


                            A Dance with Monkeys

                            R2E


                            "run" "to" "eat"

                              trent - don't be a priss.

                              i find the sunshine beckons me to open up the gate and dream and dream ~~robbie williams

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