Yep, you can clearly see the attitude of some just by their posts on this thread.

My doctor told me 20 years ago that if I think there may be an issue, to come in and we will deal with it. He would much rather have me find it was nothing than like you example. So sorry to hear.

My brother kept putting off having his colonoscopy. Finally had it like at 53 and guess what, they found cancer. They hope they got it all but they never know.

So for me, I will use the medical insurance I pay for at anytime I think there may be an issue. Just had a 1K xray on my leg since was not clear if I just had shin splits. Did the same thing with neck pain.
This is my third stress test and will have another one anytime I continue to feel I might have some heart issues. One of these days the results will not be positive but I hope to at least say it was not
because I was stubborn.

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Dave Campbell | Facebook | @DaveECampbell | h2ofun@h2ofun.net

Boom Nutrition code 19F4Y3 $5 off 24 pack box | Bionic Runner | PowerCranks | Velotron | Spruzzamist

Lions don't lose sleep worrying about the sheep

One of the best tests to have done to gain solid info about your heart health is the Coronary Calcium heart scan to determine if you have any calcified plaque. Better than stress tests. Better than cholesterol tests. Best $100 bucks you could spend.

Also you could have a VAP cholesterol test done.

Armed with the results from these two tests you and your doctor will have solid information to work with. If the numbers are good you probably won't need anything further. If the numbers reveal calcified plaque or other concerns you can have a stress test annually and begin to alter your diet and begin taking appropriate medication.

Good luck and stay healthy!

Cardiac MRI is probably the best choice for asymptomatic individuals who wish to know if they have significant coronary artery disease

Exactly. It's the one test that allows you and doc to see what is going on with the heart.

If a patient has already had a normal stress test, they should still get a calcium score. Stress testing only identifies people with obstructive coronary artery disease (i.e. those with a >50-70% stenosis). It can not differentiate patients who have no coronary artery disease from those who have substantial disease that is not yet obstructive.

Coronary artery calcium scoring is a screening test that uses a CT scanner to identify coronary artery disease at an early, preclinical stage, years before the occurrence of symptoms. It not only identifies the presence of disease, but also quantifies the amount of calcified plaque, thereby allowing comparison of the results to the normal population. Coronary artery calcium scoring is sometimes referred to as a "heart scan," "ultrafast ct scan," or "EBCT scan."

56, never had one, never had the Doctor suggest one. No family history of heart issues.

I don't have kids at home. I don't do much besides work and train. Going out racing isn't such a bad thing is it?

Great stuff. Will ask the Doc if he will try to get this test.

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Dave Campbell | Facebook | @DaveECampbell | h2ofun@h2ofun.net

Boom Nutrition code 19F4Y3 $5 off 24 pack box | Bionic Runner | PowerCranks | Velotron | Spruzzamist

Lions don't lose sleep worrying about the sheep

If you have odd chest pains then by all means get tested.

I've had odd chest pains my whole life. Hard to tell if they are getting "odder" or not. Heart stumbles sometimes but that isn't when I feel pain.

I see nothing wrong with having a few tests, especially when we get older, to make sure those odd chest pains are nothing, but this is just me. I try to be
overly picky with my health.

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Dave Campbell | Facebook | @DaveECampbell | h2ofun@h2ofun.net

Boom Nutrition code 19F4Y3 $5 off 24 pack box | Bionic Runner | PowerCranks | Velotron | Spruzzamist

Lions don't lose sleep worrying about the sheep

Just got a call from my Doc's office saying my stress test was fine. I said what timing, so I asked her if should could ask the doc about would he think this test made sense to also do and would he put in for approval.
Will see what I get back.

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Dave Campbell | Facebook | @DaveECampbell | h2ofun@h2ofun.net

Boom Nutrition code 19F4Y3 $5 off 24 pack box | Bionic Runner | PowerCranks | Velotron | Spruzzamist

Lions don't lose sleep worrying about the sheep

I would suggest that people getting exercise stress testing do a review of the test characteristic (e.g. Sensitivity and specificity). In a low risk population the likelihood of a false positive is unacceptably high. That doesn't mean that people shouldn't get evaluated or have risk factor modification. However, for most people on this forum EXERCISE stress testing is not the right test.

Additionally, for people considering cardiac CT for "Calcium scoring" should review the test characteristics for that as well. There is only moderate correlation between coronary artery disease and calcium scoring. And for outcomes it turns out that soft plaque rupture (the non calcified kind not seen on CT) is more likely to cause a heart attack.

Remember that most doctors are not used to taking care of fit patients so their perception of your individual risk is probably not accurate. I want you all to be health and feel reassured that there are no unforeseen risks; however, you also all should be informed consumers.

That is why I am asking. I love to hear different thoughts on things.

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Dave Campbell | Facebook | @DaveECampbell | h2ofun@h2ofun.net

Boom Nutrition code 19F4Y3 $5 off 24 pack box | Bionic Runner | PowerCranks | Velotron | Spruzzamist

Lions don't lose sleep worrying about the sheep

Completely understood.

I am not a cardiologist. I do not specialize in endurance athletes in fact far from it. But I do know that the advice that some in this thread have received from their physicians is likely misguided. I am not suggesting that anybody's doctor is bad but it is quite possible they haven't systematically considered the best way to assess for cardiac risk in an endurance athlete and which test might be best to do so.

It is also possible that there have not been large enough studies in a cohort of patients like those in this forum to be able to even give logical advice. I would imagine that most of the information about which test might be best would have to be extrapolated from the results of other studies.

I agree. Thanks

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Dave Campbell | Facebook | @DaveECampbell | h2ofun@h2ofun.net

Boom Nutrition code 19F4Y3 $5 off 24 pack box | Bionic Runner | PowerCranks | Velotron | Spruzzamist

Lions don't lose sleep worrying about the sheep

A stress test would have never detected the aortic aneurysm I had been training and racing with this summer. It showed up on an x-ray. That brought my racing and training to a very abrupt stop. Very bummed out about the whole thing but lucky to have caught it before I became a statistic. Now I need to find a new hobby, any suggestions??

I've always wondered why my insurance premiums are so high. I guess people getting stress tests and exposure to ionizing radiation for fun is part of the reason

I am 67 and do I get out of breath? Yes, when I am trying to keep pace with my 30 something friends, sure I do. Is this unusual? I don't think so and neither does my PCP but as preventative maintenance both of us believe in stress testing.

My stress test 5 years ago showed 70% obstruction in the right side of my heart and I elected to control it with medication rather than invasive action. This week I head back for another stress test with fingers crossed. If I never had a colonoscopy I would be dead. If I never went to a dermatologist I would be dead. I've lost friends who said "I'm fit, I don't need to see a doctor" and there are doctors who said "if he had only come in for a few simple tests he would still be with us today". You take your bike in for tune ups and preventative maintenance, you owe it to yourself and your family to do the same for your way more complicated body...... and BTW, if you voted for the current resident of the WH stop whining about healthcare premiums, this is the change you endorsed.

"There is only moderate correlation between coronary artery disease and calcium scoring."
Now that more studies have been completed, wiuld you say the same?

Interesting that this thread was resurrected as I just finished reading The Haywire Heart, How too much exercise can kill you and what you can do to protect your heart. On the plus side for not having heart issues: I'm not tall, I'm not vegan, I don't have any high life stress, I rarely drink alcohol, and I have low blood pressure. So while Dave should have gotten a test since he is tall and says he had symptoms, I'm still not going to get a stress test. I just don't see the need; and I don't have any contributing factors beyond being old, male, and a lifelong endurance athlete. But I'm now aware of A-Fib symptoms that can stem from decades of endurance training.

Also, for those who advocate against supplements, you might want to read this book and think about the ones recommended for your heart. Two that I was already using mentioned in the book are CoQ10 and Magnesium. However, I'm going to switch to a more potent Magnesium supp recommended by Thomas Gerlach in another thread (MgSport).

Response to Dave on what foods contain magnesium. From the book: "Natural sources include whole grains, fish and seafood, leafy green vegetables, soy products, brown rice, bananas, apricots, seeds and nuts. The foods highest in magnesium include kelp, tofu, figs, and pumpkin seeds."

Unless you are SURE your diet is rich in these foods, the book goes on to say "....you might consider an 'insurance' dose of magnesium from a high-quality multivitamin or mineral supplement." Reading all the case stories in the book reinforced my belief that taking certain supplements is a wise choice.

It is quite frequent that endurance athletes suffer from one or more of the following: Iron, Vitamin D, and Magnesium. I can't find the exact figure, but I believe every athlete that goes to the OTC in Colorado Springs goes through a blood test as part of the initiation process. Some crazy number of athletes were deficient in one or more of the above. I am sure you have seen my latest piece, on my athlete blood test, but for the people out there that aren't into to popping sups then a blood test is a good alternative to see where you are levels are at. You can then choose only to supplement if you are deficient then.

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Vitamin D deficiency sounds strange if you are training outside exposed to sun

Right, that is why so many athletes are shocked when they find out they have low Vitamin D. My Vitamin D isn't even that high despite supplementing 2x a day, 2000iu AND swimming outside, midday in Florida. I think you would be surprised just how many endurance athletes have low Vitamin D. I can't even imagine the normal athlete who doesn't see that much sun.

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...or live in places like Denmark where the exposure to sun is minimal despite training outside :)

Haha, or in the Northeast part of the US

I have some family history with heart disease, and had a friend have a heart attack following a race. It was enough for me to ask my doctor for one ... he ordered it up. Everything was clean. The $200 co-pay was well worth the peace of mind.