Yes those pains we get in the chest area are most often just thought of as muscle, or nerve related. Really glad you got to the bottom of it so quickly, and yes, it is great to have friends in high places. Well at least the places you need the most when this stuff strikes. With all the therapies there are now, they should get you fixed up in no time, and you will be able to continue on with your life of health and fitness.

Your dad will just have to wait... (-;

Keep us posted on your progress, these threads help a lot of folks here..

Thank you for the kind encouragement. I have to defer the Cal Tri Playa Del rey it’s in a few weeks. That will be a nope …..

Thank you for sharing.
As much as it may be "minor", from the patients (and your) perspective these things are never minor.
If you are being down on yourself, take heart (worst pun and dad joke ever) from the fact that this happened when it did, how it did and with all you are surrounded by in your health care environment.
I am an MD, but not an interventional cardiologist so cannot (and would not) give you tips on what they may do from here (ie whether they would stent it). Safe to assume though that there will be a decent look at your lifestyle and risk factor modifications, and likely the usual gamut of drugs to manage your blood pressure, cholesterol and some to decrease blood clotting mildly.
Also, this is ST, so make sure you take all medical advice from your treating team, not from any potential internet experts (although we do have some bonafide, world leading medical experts on this forum).

Thank you. I see slowtwitch as a place for sharing. My method will be to follow their guidance and not just “looking for the answer I want to hear”

I tend to gravitate towards the most reasonable solutions.

Did you ever get told what your troponin peaked at? Sounds like you are in a good place.

Yesterday I took a cake over to the local emerg. I do that to support local emerg and thank them for taking care of my patients when they need the emerg. I am in primary care and used to do emerg shifts up until about 12 years ago. They are quite stressed out in our part of the world. When I worked there I never saw Hallway medicine. Now people are parked in the hallways, mostly old people with any number of things like abdominal pain. We still do quite well with super acute things like heart attacks but the grind of many old people is difficult to do.

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They constantly try to escape from the darkness outside and within
Dreaming of systems so perfect that no one will need to be good T.S. Eliot

Thank you. I can confirm the feeling was “well this sucks”. I never got a “something really bad just happened” feeling.

warning symptoms of big cardiac trouble are unique to the patient-

I could tell you stories........................

but, most patients admit that they knew something was wrong-that's the point to get help

I agree: it was the next morning i got the “something isn’t right” feeling

Without knowing yet it probably peaked at 0.09.
Yes I have much respect for them. The times I worked in the ED area i always felt “in the way” even from Midnight to 4am Mondays. Watching how fast they zip from computer to computer gave me more insight that everything needs to be running optimal or they can’t work effectively.

Welcome to the LAD club. Very happy to hear that the event happened the way it did and you didn't ignore things. I was also a "all my arteries were crystal clear except my LAD. In my case, we have tracked things back to extremely elevated high LP(a) as the likely root of the issues. You will be back at it quickly.

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Team Zoot

Thank you for sharing and commenting. As you mentioned LP(a) I’m sure every day i’ll have a “Today I Learned” moment.

They have taken so much blood from me the last 2 days i’m sure there will be lots to talk about.

From 2011 to 2017 my performance in triathlon peaked. I remember my annual blood tests were stellar. So up until age 41 I was a “model citizen” and 20 lbs lighter than today.

Two biggest changes 2017 I divorced my wife and took custody of the children for three months eventually rolling back to 50/50. I ended up just eating what the kids wanted most of the time - my diet didn’t degrade %80 or anything but it wasn’t as clean as it was.

2019 my employer who is a fixture here in Newport Beach and typically employed people until retirement at the direction of Accenture outsourced all Info Tech and operational administrative jobs. I went through the stress of that then right into the supervisor role for the hospital then the covid lockdown started just 6 weeks into my brand new job.

During these last 5 years things were more chaotic and I often had to “eat what i could catch” for about %40 of my diet. I still got in my standard training volumes however.

So as the days roll on from here on out it will be very interesting if the flawed 5 years or genetic heat disease factors contributed more.

Thinking out loud my running speed slowed an additional 2 minutes per mile the last year. I thought it was the result of weight gain and also aging legs with that weight. I was planning on seeing what happened after a few weeks off and weight loss. Maybe that was the beginning of changes…..

Family history was always a worry for me. My maternal grandfather died from a "surprise" heart attack when he was 48 even though he worked a physical job (HVAC). My dad had multiple bypass surgery in his low 40's and my younger brother had a valve replacement in his 30's. I knew that I was at high risk even with my lifelong endurance sports involvement. I made it to 55 before I had a heart attack while on a trail run. Fortunately, I was almost finished and was able to walk to my car and drive home (not smart I now know) and have my wife drive me to the hospital (also not smart).

People around here often complain about our local hospital, but I must say that I could not possibly have been treated better than I was.

As for "minor" heart attack. People have occasionally asked if mine was a "bad one", to which I answer "the worst I ever had". :)

Hope your recovery goes smoothly!

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Happy trails,
Chris

Lucky you to have caught it and are getting treatment. What is the treatment with 50% blockage? Insurance only covers stents of 70% plus blockages?

I just finished over 4 months of tests because of lingering post Covid symptoms and these threads on ST. High HR and exhaustion. CRP was 6.7 and now back to normal after 3 months. For me everything is normal but the make up of my LDL (never more than 96 BTW) with LP(a) of 287 and worst my Cardiac Calcium Score was 786!! I did however crushed the stress test, no symptoms of blockages, 65Vo2Max etc.. Currently now on Statins. So I am a ticking time bomb if a rupture happens I guess.

Sorry to hear this and I hope you will watch out and make things better in the future.
What is your diet like? A friend of mine, his dad had quadruple bypass surgery and his diet is basically pepsi and fried chicken as they are from deep south.

Finally spoke to the cardiologist this morning. After reviewing all the test results he strongly disagrees with the other physicians that it was a minor heart attack but instead it was pericarditis / myocarditis attack and the %50 blockage they reported is more like %30 and quite normal.

This downgrades it to a generic “heart disease” category and the 0.07 troponin reading was from the damage as a result of all the inflammation.

He recommends to work closely with Primary Care physician on managing cholesterol and risk factors and there are no concerns at this time. So that’s good news!

Once I get my test results back i can share the key numbers here. So this means no stent no procedures and nothing else to do with my heart. My chest and neck still hurt terribly so i’m still going to defer the October 23rd Playa Del Rey event. Our chief medical information officer who is also practicing physician here has been speaking with my doctors and stopped by this morning . He also provided the analogy it’s like if you had a bad ankle sprain would you really want to continue on with a marathon you signed up for in a few weeks and suffer through the whole thing. Plus i’m just sitting in a bed I have no idea how it’s going to feel one I drove home and get groceries etc…..

I’ll have to update the title of my post to PSA I have joined the carditis club.

I eat very well i stay away from processed foods mostly. Fruit daily, oatmeal daily, rice or grains daily. Vegetables almost daily. Dinner is chicken, beef, pork, fish based. I eat sweet potatoes i’ve never been a vegetable lover i just make myself eat them. My biggest vice is wine and beer. I could drink less - the calories and guilt factor are enough to stop at two though. Sadly my tolerance is high- Dads lineage traced to Kentucky. In their family drinking all the time was a normal thing. My paternal grandfather would have binges and disappear for days.

When i was a young buck I was a bodybuilder and shredded looking so i know what i need to eat. But having my children almost full time I just didn’t want to be the “triathlon food police dad” so we have an abundance of kids favorites mixed in with my diet.

My diet is %70 olympian %30 middle school!

As far as getting back to your car and driving back I think a lot of us guys do that because we don’t want to create a big scene and stir everyone up if we are able to stand and move. Don’t feel too bad about it. Turns out I hade acute inflammation and I would have summoned an ambulance for that ….

:
Finally spoke to the cardiologist this morning. After reviewing all the test results he strongly disagrees with the other physicians that it was not a minor heart attack but instead it was acute pericarditis / myocarditis attack and the %50 blockage they reported is more like %30 and quite normal. He recommends to work closely with Primary Care physician on managing cholesterol and risk factors and there are no concerns at this time. So that’s good news!

Don’t beat yourself up for not calling an ambulance. I think a lot of us guys do that if we are able to stand and walk. In my case it turns out it was acute pericarditis / myocarditis and I would have summoned an ambulance just for that.

Finally spoke to the cardiologist this morning. After reviewing all the test results he strongly disagrees with the other physicians that it was a minor heart attack but instead it was pericarditis / myocarditis attack and the %50 blockage they reported is more like %30 and quite normal. He recommends to work closely with Primary Care physician on managing cholesterol and risk factors and there are no concerns at this time. So that’s good news! Calcium score is very high 99th percentile to that’s something to work on. They will have me on baby aspirin and anti inflammatory for a few weeks.

Could it be a side effect from one of the vaccines? It is one of the known but rare side effects for mRNA vaccines according to the CDC

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What's your CdA?

Physicians confirmed its a thing - but they don't see it in patents my age (middle age) and I've already had the vaccine for covid three times - I get flu annually.

Shareable items from the discharge summary: Don't need to talk my anxiety and Zoloft :)
Staff names and titles redacted:

Active Hospital Problems
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Chest pain
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Elevated troponin
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Hypotension
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CAD (coronary artery disease)


Reason for Admission
Patient was working out on an indoor bike. About 1 hour later, he developed central chest pain that felt sharp. The pain recurred so he came to the hospital for further evaluation. He denies recreational drug use and is not a smoker. No loss of consciousness. Patient denies any cardiac history, but does have a positive family history in his father for congestive heart failure.

In ER, CXR negative. CT coronary angio showed plaque in LAD with 30% stenosis. There is also abnormal soft tissue within the anterior left cardiophrenic fat. Patient's calcium score was in 99th percentile. Troponin 0.09 -> 0.07. EKG with minimal ST elevation in II, V4-V6 and T-wave inversion in III. Repeat EKG still showed ST elevation. He was admitted for further evaluation.

Hospital Course
Patient was admitted for chest pain. Troponin peaked at 0.09 and downtrended. EKG with somewhat diffuse ST elevations. On further questioning, patient recently received a COVID booster 9/29/22 so pericarditis was on the differential. CRP elevated but ESR normal. CT coronary angio showed abnormal soft tissue in left cardiophrenic fat. Differential includes ectopic thymic tissue vs hemorrhage. Patient was started on prednisone due to concern for possible hemorrhage, but echo unremarkable and did not show signs of hemopericardium. He was switched from prednisone to ibuprofen and colchicine x7 days per cardiology recommendations. CT coronary angio also showed that his calcium score was 99th percentile for age. He was started on baby aspirin for risk stratification. Patient was discharged on baby aspirin, ibuprofen and colchicine for pericarditis. He was also given a course of protonix while he is on NSAIDs. Patient recently found a new PCP but has not established care with him or her yet. He was instructed to make an appointment in 1-2 weeks.

Patient had fever during this hospitalization. Infectious work up was negative. He was monitored off antibiotics and fever resolved on its own.

Discharge Physical Exam

[/url]Temp: 36.7 °C (98.1 °F)
Pulse: 68
Resp: 17
BP: 114/85
SpO2: 95 %[/url]

General: no acute distress
Chest wall: nontender to palpation
Lungs: CTAB
Heart: RRR
Abdomen: soft, nontender, nondistended. Normal bowel sounds
Extremities: no LE edema
Neurologic: nonfocal
Psych: appropriate mood and affect
Radiology Results from this Hospitalization

1. Predominantly calcified plaque within the proximal LAD results in 30 percent stenosis. Minimal calcified plaque in the RCA without significant stenosis.

2. Abnormal soft tissue within the anterior left cardiophrenic fat, abutting the pericardium adjacent the left ventricle. Differential diagnosis includes ectopic thymic tissue, or hemorrhage. Unlikely to be neoplasm such as lymphoma. A short interval
follow-up CT in 6-8 weeks would be helpful to monitor for either stability, or regression.

3. Calcium score of 230 is 99 percentile for age.

Radiology Results from this Hospitalization

I agree that the testimonies of fit athletes having cardiac issues is eye opening for a lot of us. My wife saw me watching the TO breakdown of his cardiac event and then began her beckoning for me to go get a thorough screening. I'm in my mid-30's so the cardiologist was a bit hesitant to order the scan of my heart and surrounding arteries, but eventually did acquiesce as he could tell my wife wasn't going to let me race without the scan. Everything came back normal, but I plan to go back for a repeat scan when I hit my 40's. Insurance was a bit of nuisance as well, but we were able to navigate around their red tape with a few "exaggerations" of symptoms. As my cardiologist stated: "Don't hate the player, hate the game."

Glad you got some good news today and were quick to respond to warning signs.

Official numbers:

1. Predominantly calcified plaque within the proximal LAD results in 30 percent stenosis. Minimal calcified plaque in the RCA without significant stenosis.
3. Calcium score of 230 is 99 percentile for age.

I believe you did all the right things. TO's issue scared me also. I always thought if we have cardiac problems, it reveals itself a few times in training and racing - NOPE. After 40 if we are a ticking time bomb that's when it's more likely to show up.

As you stated - without the ER I would have had to "play the game" to get some of these tests.

One of my co-workers at the previous company - Cyber Security - lean and muscular bodybuilder - think "Carl Weathers - Apollo Creed 1980s" died suddenly at 37 from heart failure.