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Re: Sudden death in triathlon [dtoce] [ In reply to ]
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http://tripothesis.com/...hletes-be-concerned/

Recently addressed it here. Thoughts?

http://www.tripothesis.com - Comprehensive Tri and running training plans starting at only $10.
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Re: Sudden death in triathlon [hydark] [ In reply to ]
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It sure seems to mirror general population statistics at first glance. Not sure how excited I'm supposed to be that triathletes/marathoners/etc aren't immune from cardiovascular disease



//Noob triathlete//bike commuter//ex-swimmer//slower than you

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Re: Sudden death in triathlon [doug in co] [ In reply to ]
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Hello doug in co and All,

That is not an encouraging chart you posted ..... I hope my wife doesn't see it ......

On the other hand 'Old age isn't so bad when you consider the alternative'. Maurice Chevalier

Age affects many human functions .... including eyesight, hearing, balance, reflexes, and cognitive skills ..... as a general rule it is not good news to be at the back of the herd age wise .....




https://www.theguardian.com/...s-police-netherlands


Excerpt:


"Figures released this week show that more people are now being killed in the Netherlands while riding an electric bike than a moped, and nearly 90% of fatalities were aged 60 or above. [emphasis added]


The death toll has prompted Dutch police to call for those who start riding bikes fitted with a motor to take a safety course."

“People are staying mobile for longer and are more likely to go for an e-bike,” Egbert-Jan van Hasselt, who heads the Dutch police road safety unit, told the Dutch newspaper AD.

“In itself, that’s nice because it’s healthy. But unfortunately some of the elderly lack the ability. [It is] not a normal bike.”

Cheers, Neal

+1 mph Faster
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Re: Sudden death in triathlon [Freddo] [ In reply to ]
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Freddo wrote:
It sure seems to mirror general population statistics at first glance. Not sure how excited I'm supposed to be that triathletes/marathoners/etc aren't immune from cardiovascular disease


But, it was true that the higher even rate appears to be more with 'first timers' to USAT (40%).
*And no elites or pros, so maybe that is what I should shoot for
Perhaps 'seasoned' athlete's are truly at less risk.

And I went from running (marathons) to triathlon which apparently didn't lower my risk but I'm sure having more fun.
I do love the bike, it's just that d*mn S part of the race.. and no e-biking when I lose my reflexes...
;)

Dale

(nice chart, BTW)
Last edited by: dtoce: Sep 22, 17 18:56
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Re: Sudden death in triathlon [dtoce] [ In reply to ]
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OK, I have not posted in years, but to update, I had a heart attack in 2009, then I had a second one in 2013, after I did an Ironman. My cardiologist tells me it's ok to still workout, so I had stroke, level 18, 2015, so it has been a crazy ride. I still workout some everyday and enjoy doing the cycling and running. The problem is I don't know if I could ever stop. Im 61 yr old now, and don't put the hammer down as much, but every once in a while, I will still open it up. Today, I ran and rode!
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Re: Sudden death in triathlon [dtoce] [ In reply to ]
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Very interesting study. I'm 70 years old and recently had a stress test which was fine. I've done many ironmans, working out for greater than 30 years, and am signed up again this year for another. Due to my cholesterol level, (240 total, with an HDL of 105), my cardiologist had me take a Coronary Calcium CT. It came back clear (0, 3, 4) in 3 arteries but 334 in the LAD (51%). This blew my mind and I'm trying to figure out what to think about this. No symptoms, nothing. I noticed the last statement saying calcification is greater in exercising males, but is more stable. Any thoughts on how I should proceed? I'm in the process of getting a new Lipid profile and then will most likely hear the cardiologists recommendations. I'm in total shock right now and wondering how to come to grips with this.
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Re: Sudden death in triathlon [trinerd1] [ In reply to ]
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This is exactly why sometimes diagnostic tests are not that good of an idea. Now you are scared and feel like you got to act on it. When your stress test is fine and you have no symptoms, I see no reason to go for a CT or a coronary angiography other than your doctors wallet. Do you have any other risk factors?
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Re: Sudden death in triathlon [bentus] [ In reply to ]
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No other risk factors other than my age. I feel good, no symptoms. He recommended the test because of my cholesterol. We had a discussion whether total cholesterol is the bad number or if the ratio of HDL is the number to look at. My HDL is out the roof, triglycerides very low, about 130 ldl which isn't great. He was honest and said there is a big debate over the most important numbers so here comes the CT scan. As said previously, I don't know what to say. I think this indicates preliminary heart disease, yet I'm doing marathons, long trail runs, ironmans, etc. Don't know how to progress from here.
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Re: Sudden death in triathlon [dtoce] [ In reply to ]
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A comprehensive post dtoce with CAD (occult or ignored) as the main culprit and arrhythmias (occult or at least in this forum treated lightly) coming in second. I'd only add one further potential etiology...a viral endocarditis. It has been my observation that triathletes in particular are a slave to their training programmes and as races are long term targets (and hence athletes are less likely to withdraw from them) that they often train and race while suffering from a virus. Its often not thought about that a common cold can have important cardiac consequences. Take home is if you're unwell rest!

"The potential etiologies of SCD include structural heart disease, inherited arrhythmias syndromes, and coronary heart disease; the exact distribution of etiologies varies according to age and geography, among other variables. (See 'Etiology of sudden death' above and "Pathophysiology and etiology of sudden cardiac arrest"
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Re: Sudden death in triathlon [bentus] [ In reply to ]
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bentus wrote:
This is exactly why sometimes diagnostic tests are not that good of an idea. Now you are scared and feel like you got to act on it. When your stress test is fine and you have no symptoms, I see no reason to go for a CT or a coronary angiography other than your doctors wallet. Do you have any other risk factors?

This is exactly why you should not get medical advice from the internet...asymptomatic people die from undiagnosed CAD every day.


trinerd1 wrote:
No other risk factors other than my age. I feel good, no symptoms. He recommended the test because of my cholesterol. We had a discussion whether total cholesterol is the bad number or if the ratio of HDL is the number to look at. My HDL is out the roof, triglycerides very low, about 130 ldl which isn't great. He was honest and said there is a big debate over the most important numbers so here comes the CT scan. As said previously, I don't know what to say. I think this indicates preliminary heart disease, yet I'm doing marathons, long trail runs, ironmans, etc. Don't know how to progress from here.

Age is all you need. Consider getting a second opinion if there is 'debate' over the meaning/importance of your numbers or what to do with your results. You should go over this with your doctor and make sure your questions are answered and you understand risks and benefits.

That said, I often have my patients pay for a coronary CT scan out of their pocket (with no kickback or violation of any 'Fraud/Waste and Abuse'...) in order to find out if it is likely that they have CAD or not. It is a diagnostic test very specific for coronary artery calcification. The numbers are important as you can identify patients who would not otherwise be treated aggressively, perhaps avoiding a cardiac event. It's an anatomic test, not a physiologic test. It simply identifies plaque, or not. (*I've been able to stop statins in people with calcium scores of 0 too).


A calcium 'score' > 100 is highly associated with plaque in the coronary vessel=CAD. The best treatment option is almost always aspirin and a statin to a goal LDL of ~40-70.

It doesn't mean you can't live life fully and remain active. It means you need to be more vigilant (than previously) for symptoms that could be the first sign of significant CAD. Discuss it with your cardiolgist.
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Re: Sudden death in triathlon [dtoce] [ In reply to ]
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My doc prescribed a CT scan of my heart after my cholesterol spiked (historically well under 200) at an annual exam. That was three years ago (at age 51). Scared the sh*t out of me when he called me on my way home to tell me one of my arteries has "more blockage than 80% of the guys my age". Couldn't believe it as I'm fit and have been my entire life. After the initial shock and frankly panic (this is how I'm gonna die: heart attack), he put me on a baby aspirin and a statin.

Have gone back each year to repeat the CT scan and all is well. The treatment and subsequent tests have allayed my fears. Doc now says I don't need to get a CT scan each year as things have progressed positively.

DEFINITELY recommend the CT scan for the benchmark for anyone over 50 and athletic - it can be sobering but it's invaluable info.
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Re: Sudden death in triathlon [Toby] [ In reply to ]
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Toby wrote:
Mark Lemmon wrote:
Definitely concerning for this 58 year old too. It would be very helpful if someone could find and post detailed info on all the 60+ plus men who have died in tris included in this study. My hope is that they were less experienced triathletes than I am so I can theorize that my experience will mitigate my risk compared to my peers.

Thanks Larry. I will read your blog piece tomorrow morning, but not before bedtime. :)


Not just experience - it would be interesting to find out what actually happened in these cases. Were the racers fit or "fit"? Did they have congenital defects that finally got to the point where they caused problems in the water? Or is it truly random? I doubt the latter, but that's what people seem to be assuming. Could it be that men are more likely than women to train and race with poor diet and health practices and it manifests in the water, like when shoveling snow? That seems likelier than being driven primarily by age alone.

You will be disappointed at the results. Just do a forum search on the various deaths that have been posted. A few years ago we had a surge in the number of deaths during the swim, I recall that they all were fairly well trained with one being in the national championship race. It's natural to ask and even assume lack of training as a significant cause, but the scary part was that the swim deaths were occurring early in the swim. Also, read "The Haywire Heart" if you want a depressing look at the potential problems of long duration training over the years. All you can do is accept that there is the possibility of an increased risk of death, due to endurance exercise, in some portion of the endurance population. Kemoy Campbell just had an incident at the Millrose games, and he was the pace rabbit in the 3000m (he's in critical but stable condition as of last report). Keeping fit doesn't get you immunity, it does give you a better quality of life and lessens the risk of death attributed to the general population lifestyle choices.
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Re: Sudden death in triathlon [vonschnapps] [ In reply to ]
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This is a great optimistic response. When you say things progressed positively, did you CT score go down or were you happy that it stayed the same? I'm reading conflicting information, some websites say you cannot lower the score, but I believe it was a Cleveland Clinic write up (not sure) that said if the Statins get the ldl below 70 and hold it for more than 3 years, the calcium score can start reversing for the better. Interested to hear your results.
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Re: Sudden death in triathlon [vonschnapps] [ In reply to ]
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My reply below was meant to go to you, but I must have inadvertently pressed the latest post. Has your CAC score declined, or is the Dr happy that things are staying the same? Either way, congratulations to you.
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Re: Sudden death in triathlon [trinerd1] [ In reply to ]
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trinerd1 wrote:
My reply below was meant to go to you, but I must have inadvertently pressed the latest post. Has your CAC score declined, or is the Dr happy that things are staying the same? Either way, congratulations to you.

This request is for Pathlete above, (I'm not ignoring you)!
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Re: Sudden death in triathlon [vonschnapps] [ In reply to ]
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Yep, understood. It was my bad. Thanks.
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