Login required to started new threads

Login required to post replies

Lucky to be here
Quote | Reply
I thought my story could be of interest and i welcome comments.

I am a 60M who has been participating in triathlons since 2002. Probably 50+ olys, perhaps six halfs, three IMs. Retired from teaching in 2020. Covid shut races down for two years and last year it took me an extended period to recover from contracting covid myself. I dragged myself through a race undertrained and was only able to train meaningfully for the last race of the season. It went better than expected and i was stoked for this season. I finally had a chance to train like a pro and i did.

The first race went very well. The second race (this past weekend) did not. Well it did, up to a point. I found myself coming out of the water with people i am usually minutes behind. The bike is my strongest discipline and in short order i was flying up the road, passing people i normally don't pass until later, or never pass. It felt like i had a very good chance for a PR. Perhaps ten minutes after the turnaround i started feeling not so well, like chest congestion (smoke is not an issue where i am). I hoped the feeling would pass, but it got progressively worse. I had to slower and slower and s-l-o-w-e-r. My chest started hurting very badly. I debated pulling over, but opted to tick the pedals over to transition. (I'm not sure i did the right thing, but i thought i might get a faster medical response there, rather than pulling over and lying in the grass.) It was perhaps 20 minutes to get to transition. I was not going much faster than a slow jog. Along the way onlookers asked if i was okay. I said no each time.

I walked my bike from the dismount line to the rack, then walked to the announcing area and flagged down medical staff. Suffice to say it was the spectacle you imagine. Pain 8-9/10. Tri top ripped off, paddles to the chest (though no shocking ..apparently the internal electrics were okay as was my pulse and b.p.), ambulance called. It was perhaps an hour later when i was rolled into a catheterization lab. Blockage abraded, one stent applied. Being assessed a "low risk" to leave after 24 hours, i was discharged the next day. Things have settled down and i have a chance to reflect and wonder if i will be able to get back to my sport. At the hospital several medical professionals on the cardiology ward said there was no reason i couldn't get back to my sport, in time. In fact, this was encouraged and in two cases unsolicited, including from the cardiologist and later his assistant (who is an avid runner and was very curious about triathlon). I am also fortunate to have a brother who is an ER doctor and echoes the sentiment.

A few things about me: i have never smoked; i have no allergies or conditions; there is no history of heart disease in my family; i take no meds (well i do now); i drank socially but gave up alcohol six months ago; i have had borderline high blood pressure for decades but my b.p. has come within normal range since foregoing alcohol; i have a sweet tooth and probably ingest more sugar than i should; i am not diabetic. In consultation with my GP, i have been on a plant-based diet for the past four years. She knows i am an athlete. I supplement B12 and iron. I get a blood panel every year. Everything is well within healthy ranges. Doc says, "Whatever you're doing keep it up." This is the part where i wish i had known then what i know now.

I probably have the normal amount of plaque in my arteries for a person my age. The biggest contributor to these deposits is cholesterol and in my life i have consumed my fair share of animal products, the only source of LDL cholesterol. Unfortunately, once deposited, plaque is there for life ..unless it breaks away and subsequently forms a clot and induces a heart attack or stroke, which is most likely when we are subjecting our bodies to stress. Triathlon qualifies.

It's rare for anyone to do everything right, and i don't claim to, but i think most of us do more things right than the general population. I am lucky to be here. The one regret i have is i wish i had given up eating animal products earlier, like decades earlier. My arteries would be a lot clearer and my cardiovascular health better for it. For me now it seems like a no-brainer.

Thanks for taking the time. I welcome your thoughts.
Quote Reply
Re: Lucky to be here [TriBiker] [ In reply to ]
Quote | Reply
Wow! Glad it appears you will be ok. Scary!!

David
* Ironman for Life! (Blog) * IM Everyday Hero Video * Daggett Shuler Law *
Disclaimer: I have personal and professional relationships with many athletes, vendors, and organizations in the triathlon world.
Quote Reply
Re: Lucky to be here [TriBiker] [ In reply to ]
Quote | Reply
Thanks for sharing! Glad you're ok now, and wish you speedy recovery and hope you'll get back out there without a repeat of this!

Is there anything special you're being recommended to do going forward? Have you ever had a coronary calcium scan?
Quote Reply
Re: Lucky to be here [TriBiker] [ In reply to ]
Quote | Reply
I am not an expert on this, but my understanding is genetics play as much of a role as lifestyle. I have a family history of high cholesterol and have been on statins since I was 30. Needed them even when I was in my best shape to keep the numbers in check. If I take the minimum dose I have great numbers, if I don't take any meds numbers sky rocket no matter the diet and exercise.
Quote Reply
Re: Lucky to be here [TriBiker] [ In reply to ]
Quote | Reply
TriBiker wrote:
I thought my story could be of interest and i welcome comments.

I am a 60M who has been participating in triathlons since 2002. Probably 50+ olys, perhaps six halfs, three IMs. Retired from teaching in 2020. Covid shut races down for two years and last year it took me an extended period to recover from contracting covid myself. I dragged myself through a race undertrained and was only able to train meaningfully for the last race of the season. It went better than expected and i was stoked for this season. I finally had a chance to train like a pro and i did.

The first race went very well. The second race (this past weekend) did not. Well it did, up to a point. I found myself coming out of the water with people i am usually minutes behind. The bike is my strongest discipline and in short order i was flying up the road, passing people i normally don't pass until later, or never pass. It felt like i had a very good chance for a PR. Perhaps ten minutes after the turnaround i started feeling not so well, like chest congestion (smoke is not an issue where i am). I hoped the feeling would pass, but it got progressively worse. I had to slower and slower and s-l-o-w-e-r. My chest started hurting very badly. I debated pulling over, but opted to tick the pedals over to transition. (I'm not sure i did the right thing, but i thought i might get a faster medical response there, rather than pulling over and lying in the grass.) It was perhaps 20 minutes to get to transition. I was not going much faster than a slow jog. Along the way onlookers asked if i was okay. I said no each time.

I walked my bike from the dismount line to the rack, then walked to the announcing area and flagged down medical staff. Suffice to say it was the spectacle you imagine. Pain 8-9/10. Tri top ripped off, paddles to the chest (though no shocking ..apparently the internal electrics were okay as was my pulse and b.p.), ambulance called. It was perhaps an hour later when i was rolled into a catheterization lab. Blockage abraded, one stent applied. Being assessed a "low risk" to leave after 24 hours, i was discharged the next day. Things have settled down and i have a chance to reflect and wonder if i will be able to get back to my sport. At the hospital several medical professionals on the cardiology ward said there was no reason i couldn't get back to my sport, in time. In fact, this was encouraged and in two cases unsolicited, including from the cardiologist and later his assistant (who is an avid runner and was very curious about triathlon). I am also fortunate to have a brother who is an ER doctor and echoes the sentiment.

A few things about me: i have never smoked; i have no allergies or conditions; there is no history of heart disease in my family; i take no meds (well i do now); i drank socially but gave up alcohol six months ago; i have had borderline high blood pressure for decades but my b.p. has come within normal range since foregoing alcohol; i have a sweet tooth and probably ingest more sugar than i should; i am not diabetic. In consultation with my GP, i have been on a plant-based diet for the past four years. She knows i am an athlete. I supplement B12 and iron. I get a blood panel every year. Everything is well within healthy ranges. Doc says, "Whatever you're doing keep it up." This is the part where i wish i had known then what i know now.

I probably have the normal amount of plaque in my arteries for a person my age. The biggest contributor to these deposits is cholesterol and in my life i have consumed my fair share of animal products, the only source of LDL cholesterol. Unfortunately, once deposited, plaque is there for life ..unless it breaks away and subsequently forms a clot and induces a heart attack or stroke, which is most likely when we are subjecting our bodies to stress. Triathlon qualifies.

It's rare for anyone to do everything right, and i don't claim to, but i think most of us do more things right than the general population. I am lucky to be here. The one regret i have is i wish i had given up eating animal products earlier, like decades earlier. My arteries would be a lot clearer and my cardiovascular health better for it. For me now it seems like a no-brainer.

Thanks for taking the time. I welcome your thoughts.


Wow so very sorry to hear what you went through

Very glad you are much better

You said:

I probably have the normal amount of plaque in my arteries for a person my age. The biggest contributor to these deposits is cholesterol and in my life i have consumed my fair share of animal products, the only source of LDL cholesterol.


What were your cholesterol numbers?

Your coronary calcium score?
Last edited by: MrTri123: Jun 28, 23 12:59
Quote Reply
Re: Lucky to be here [TriBiker] [ In reply to ]
Quote | Reply
TriBiker wrote:
I thought my story could be of interest and i welcome comments.



I get a blood panel every year. Everything is well within healthy ranges. Doc says, "Whatever you're doing keep it up." This is the part where i wish i had known then what i know now.

. I welcome your thoughts.

Glad to hear you survived and are doing OK.

If you don't mind, it would be interesting to know your actual blood panel results for total cholesterol, LDL, HDL, triglycerides and APO-B if by chance you've had that measured. I've heard too many stories about GPs who said everything looked fine when if one looked with a cardio focused lens those in the know might say "not so much"

Thanks,

Hugh

Genetics load the gun, lifestyle pulls the trigger.
Quote Reply
Re: Lucky to be here [friskyDingo] [ In reply to ]
Quote | Reply
friskyDingo wrote:
Is there anything special you're being recommended to do going forward? Have you ever had a coronary calcium scan?

I have not. I will ask about this. I understand it is a CT scan. I will ask about this.
Quote Reply
Re: Lucky to be here [TriBiker] [ In reply to ]
Quote | Reply
Glad you survived that scare! I wonder if you hadn't done the triathlon if you still would have had an "event" sometime later. I got my wake up call when I went in for an x-ray of my lower spine (back pain). Besides arthritis and some scoliosis, the surprise diagnosis was severe aortic atherosclerosis. WTF? I've been told most of my life that my cholesterol numbers are great. I certainly have eaten my fair share of meats in the past 66 years, but I didn't expect that to show up. I'm scheduled for the calcium score in a couple weeks. I do have a sprint tri next weekend and I asked my primary if I should modify my lifestyle (avoiding extreme heartrate) and she said since I wasn't symptomatic not to worry. Well, after reading stories like yours that have been posted on here over the years I find it a little hard not to.
Quote Reply
Re: Lucky to be here [sciguy] [ In reply to ]
Quote | Reply
sciguy wrote:
If you don't mind, it would be interesting to know your actual blood panel results for total cholesterol, LDL, HDL, triglycerides and APO-B if by chance you've had that measured. I've heard too many stories about GPs who said everything looked fine when if one looked with a cardio focused lens those in the know might say "not so much"

Thanks,

Hugh


Total cholesterol: 4.63 mmol/L
LDL: 2.65 mmol/L
HDL: 1.66 mmol/L
Triglycerides: 0.70 mmol/L

ApoB not tested and doesn't look like there's a checkbox for one, but i will ask at my next panel (next week). C-reactive protein also not tested, but there is a checkbox for that, so i will request since it's another good thing to know.
Quote Reply
Re: Lucky to be here [TriBiker] [ In reply to ]
Quote | Reply
TriBiker wrote:
he biggest contributor to these deposits is cholesterol and in my life i have consumed my fair share of animal products, the only source of LDL cholesterol.

No. Dietary animal cholesterol has minimumal impact. cholesterol (hdl,ldl) is made from the fats you eat, animal or non animal. carbohydrates can influence the density of these particles.
Quote Reply
Re: Lucky to be here [TJ56] [ In reply to ]
Quote | Reply
TJ56 wrote:
Glad you survived that scare! I wonder if you hadn't done the triathlon if you still would have had an "event" sometime later. I got my wake up call when I went in for an x-ray of my lower spine (back pain). Besides arthritis and some scoliosis, the surprise diagnosis was severe aortic atherosclerosis. WTF? I've been told most of my life that my cholesterol numbers are great. I certainly have eaten my fair share of meats in the past 66 years, but I didn't expect that to show up. I'm scheduled for the calcium score in a couple weeks. I do have a sprint tri next weekend and I asked my primary if I should modify my lifestyle (avoiding extreme heartrate) and she said since I wasn't symptomatic not to worry. Well, after reading stories like yours that have been posted on here over the years I find it a little hard not to.

To my understanding, blood serum cholesterol levels only indicate how much cholesterol is flowing through our vessels. It does not indicate how much plaque has been laid down over the years. To me it's not unlike the nicotine in cigarettes. No one doubts every cigarette smoked does small but cumulative damage. It's the same with the cholesterol that is in every bite of food that contains animal products, whether it's flesh or secretions (dairy and eggs).

I have little doubt i was bound to experience a coronary event at some point (most of us do - heart disease is the #1 cause of death in the west). Maybe with every workout and race that date is moved closer, especially if we have compromised cardiovascular health. But maybe our sport is also what makes us feel alive and allows us to experience a better quality of life. So do we retire from the sport we love and opt for a life of leisure? Is that better? The answer is very personal.
Quote Reply
Re: Lucky to be here [TriBiker] [ In reply to ]
Quote | Reply
Glad you made it through. I always include in pre race talks that there's no shame in pulling the plug if you're not feeling*right*, and to err on the side of caution. maybe the better decision to get closer to help was the best, just glad it all worked out for you and you're mostly ok now. if you re-title your post to include heart attack or some such, you may get somebetter responses, not medical advice, but a helpful cadre of professionals that may help shed light on what to do going forward.

so when's your next race? ;-) just kidding, and good luck TriBiker!

http://www.PatGriskusTri.com USAT Certified Race Director
2024 Races: USAT State of CT Age Group Championship/State of CT HS Champs/ CT Club Championship - Sat June 15th (Oly/Du/Sprint) Hopkins Vineyard Tri at Lake Waramaug Saturday July 13th http://www.HopkinsVineyardTri.com
Quote Reply
Re: Lucky to be here [TriBiker] [ In reply to ]
Quote | Reply
glad you are ok and got help when you had symptoms which obviously needed attention

exertional chest discomfort is classic but just all too often ignored by athletes who simply think it can't happen to them....


It is critically important to never ignore serious warning symptoms. These can occur in common or unusual ways. https://www.heart.org/...ns-of-a-heart-attack

Pain which occurs due to inadequate blood supply to the heart muscle itself is called ‘angina’. Typical angina is described as an exertional chest discomfort/tightness/pain which may radiate to the neck/jaw/back or arm and can be associated with nausea/vomiting or sweating. That is exactly what Mr. O’Donnell had and even he knew it might be a heart attack but questioned it because of his excellent fitness. Angina usually occurs with activity and stops with rest but if it doesn’t stop, it can be the start of a heart attack and people should get checked out immediately. Atypical angina, which happens more frequently with women, is different and more often involves activity limiting shortness of breath, isolated neck/jaw pain/arm pain or fatigue.

Risk is higher with a poor diet, inactivity or with high cholesterol (especially elevated LDL). It is also higher if a patient has hypertension or diabetes. These are the traditional ‘risk factors’ for heart disease which people talk about. There are also ‘Risk Calculators’ available that are frequently used with a patient’s age, cholesterol and BP numbers to give additional information about future cardiac risk. You can modify behavior but you can’t change your age or genetics. https://tools.acc.org/...!/calculate/estimate

The take home message is really twofold: 1) if you have any concerning activity limiting symptoms, then you should be evaluated quickly by appropriate medical care providers and 2) CAD is widely prevalent and anyone (*over 35) can have a heart attack, even if you are very active and fit. So be smart and obey that little voice in your head when it says to you “hey, something is just not right” and get checked out. It could cost you your life if you ignore it.

Reasonable screening for risk factors for CAD should include: BP check, fasting bloodwork-checking lipids/kidney function/electrolytes and blood sugar, history/physical exam and sometimes an EKG.

Aggressive screening for CAD may include: EKG, stress test (with or without imaging) CT of the chest or coronary artery calcium score (CACS). CACS looks for any plaque buildup and is a very quick, easy, relatively inexpensive non-invasive test that can tell if the process of CAD has begun or not.

People with intermediate/high risk symptoms or testing often require a coronary angiogram or cardiac catheterization. This is a procedure done to see exactly how blocked up the arteries are and treatment can be given immediately for critically narrowed arteries with a balloon dilation procedure and a stent to deliver better blood flow in the long term. Some people with multiple critically narrowed arteries need open heart surgery with coronary artery bypass grafting (CABG).

To those out there who want to be checked, consider talking to your own doctor about coronary artery calcium scoring and making sure your own risk factors have been checked appropriately. Stay well.

The OP does not need a coronary calcium score-he has KNOWN CAD.

D.Toce MD FACC
(aka dtoce here on ST)

you asked--here are my thoughts:
https://www.slowtwitch.com/...art_Health_7911.html


info on coronary artery calcium scoring:
https://www.acc.org/...-cardiovascular-risk

Sudden death in triathlon:
https://forum.slowtwitch.com/...riathlon_P6427784-2/

another thread after T. O'Donnell's incident
https://forum.slowtwitch.com/...rt%2C%20cad#p7579078
Last edited by: dtoce: Jun 28, 23 17:04
Quote Reply
Re: Lucky to be here [synthetic] [ In reply to ]
Quote | Reply
synthetic wrote:
TriBiker wrote:

he biggest contributor to these deposits is cholesterol and in my life i have consumed my fair share of animal products, the only source of LDL cholesterol.


No. Dietary animal cholesterol has minimumal impact. cholesterol (hdl,ldl) is made from the fats you eat, animal or non animal. carbohydrates can influence the density of these particles.

in reality, the majority of cholesterol that is measured is produced in the liver as we need cholesterol for many, many things in the body and genetics sets the amount produced-and whether one's level is acceptable or not depends on CAD risk level

diet can influence cholesterol numbers by about 15-20%, depending on how bad a diet is and how much saturated fat (mostly) is eaten

certainly, a plant based diet is better than most-but food intake it is absolutely not the 'only source' of LDL but it is true that intake is far less important than how much cholesterol your own liver makes
Quote Reply
Re: Lucky to be here [TriBiker] [ In reply to ]
Quote | Reply
Glad you made it. Sounds terrifying but also probably a very good setting to have something like that happen, if it were going to happen.

Thanks for posting.

Everything about your profile sounds extremely similar to mine, except for the age, diet, and experience with triathlons. I'm younger and have been on a vegetarian diet for some time

Plant-based diets can be just as unhealthy as non-plant-based ones, and I think getting diet "right" can be tricky in general as it depends on a lot of factors, especially individual-specific ones. I know my diet isn't always as good as it could be, although I try.

Hopefully you're able to recover to normal soon. The last couple of years have thrown wildcards for a lot of people.
Quote Reply
Re: Lucky to be here [synthetic] [ In reply to ]
Quote | Reply
synthetic wrote:
TriBiker wrote:

he biggest contributor to these deposits is cholesterol and in my life i have consumed my fair share of animal products, the only source of LDL cholesterol.


No. Dietary animal cholesterol has minimumal impact. cholesterol (hdl,ldl) is made from the fats you eat, animal or non animal. carbohydrates can influence the density of these particles.

Your research take-aways and mine do not align.
Quote Reply
Re: Lucky to be here [TriBiker] [ In reply to ]
Quote | Reply
TriBiker wrote:
sciguy wrote:

If you don't mind, it would be interesting to know your actual blood panel results for total cholesterol, LDL, HDL, triglycerides and APO-B if by chance you've had that measured. I've heard too many stories about GPs who said everything looked fine when if one looked with a cardio focused lens those in the know might say "not so much"

Thanks,

Hugh


Total cholesterol: 4.63 mmol/L
LDL: 2.65 mmol/L
HDL: 1.66 mmol/L
Triglycerides: 0.70 mmol/L

ApoB not tested and doesn't look like there's a checkbox for one, but i will ask at my next panel (next week). C-reactive protein also not tested, but there is a checkbox for that, so i will request since it's another good thing to know.

If you can get them to do it, Apo-B is recognized to provide even more useful insight into the atherogenic properties of your LDL. I'd add that for those with existing CVD it's been recommended by many to drive LDL to 1.81 or lower if you really are intent on minimizing any additional plaque accumulation. This may involve even deeper dietary intervention or perhaps the use of a statin or PCSK9 inhibitor.

Best of luck,

Hugh

Genetics load the gun, lifestyle pulls the trigger.
Quote Reply
Re: Lucky to be here [dtoce] [ In reply to ]
Quote | Reply
dtoce wrote:
glad you are ok and got help when you had symptoms which obviously needed attention

exertional chest discomfort is classic but just all too often ignored by athletes who simply think it can't happen to them....


It is critically important to never ignore serious warning symptoms. These can occur in common or unusual ways. https://www.heart.org/...ns-of-a-heart-attack

Pain which occurs due to inadequate blood supply to the heart muscle itself is called ‘angina’. Typical angina is described as an exertional chest discomfort/tightness/pain which may radiate to the neck/jaw/back or arm and can be associated with nausea/vomiting or sweating. That is exactly what Mr. O’Donnell had and even he knew it might be a heart attack but questioned it because of his excellent fitness. Angina usually occurs with activity and stops with rest but if it doesn’t stop, it can be the start of a heart attack and people should get checked out immediately. Atypical angina, which happens more frequently with women, is different and more often involves activity limiting shortness of breath, isolated neck/jaw pain/arm pain or fatigue.

Risk is higher with a poor diet, inactivity or with high cholesterol (especially elevated LDL). It is also higher if a patient has hypertension or diabetes. These are the traditional ‘risk factors’ for heart disease which people talk about. There are also ‘Risk Calculators’ available that are frequently used with a patient’s age, cholesterol and BP numbers to give additional information about future cardiac risk. You can modify behavior but you can’t change your age or genetics. https://tools.acc.org/...!/calculate/estimate

The take home message is really twofold: 1) if you have any concerning activity limiting symptoms, then you should be evaluated quickly by appropriate medical care providers and 2) CAD is widely prevalent and anyone (*over 35) can have a heart attack, even if you are very active and fit. So be smart and obey that little voice in your head when it says to you “hey, something is just not right” and get checked out. It could cost you your life if you ignore it.

Reasonable screening for risk factors for CAD should include: BP check, fasting bloodwork-checking lipids/kidney function/electrolytes and blood sugar, history/physical exam and sometimes an EKG.

Aggressive screening for CAD may include: EKG, stress test (with or without imaging) CT of the chest or coronary artery calcium score (CACS). CACS looks for any plaque buildup and is a very quick, easy, relatively inexpensive non-invasive test that can tell if the process of CAD has begun or not.

People with intermediate/high risk symptoms or testing often require a coronary angiogram or cardiac catheterization. This is a procedure done to see exactly how blocked up the arteries are and treatment can be given immediately for critically narrowed arteries with a balloon dilation procedure and a stent to deliver better blood flow in the long term. Some people with multiple critically narrowed arteries need open heart surgery with coronary artery bypass grafting (CABG).

To those out there who want to be checked, consider talking to your own doctor about coronary artery calcium scoring and making sure your own risk factors have been checked appropriately. Stay well.

The OP does not need a coronary calcium score-he has KNOWN CAD.

D.Toce MD FACC
(aka dtoce here on ST)

you asked--here are my thoughts:
https://www.slowtwitch.com/...art_Health_7911.html


info on coronary artery calcium scoring:
https://www.acc.org/...-cardiovascular-risk

Sudden death in triathlon:
https://forum.slowtwitch.com/...riathlon_P6427784-2/

another thread after T. O'Donnell's incident
https://forum.slowtwitch.com/...rt%2C%20cad#p7579078

Great advice

Coronary calcium score only costs a couple hundred dollars even with zero insurance

Takes not a few minutes and non invasive. Super simple

IMO something which everyone should have as they age

I wish Drs would recommend this more especially for people with know symptoms
Quote Reply
Re: Lucky to be here [MrTri123] [ In reply to ]
Quote | Reply
This re: coronary calcium check. Had mine done two weeks ago and took less than 10 mins. Cost was super cheap also. The comfort of getting my score back (<1) and knowing this isn't an area of great concern for me - damn near priceless!

MrTri123 wrote:
dtoce wrote:
glad you are ok and got help when you had symptoms which obviously needed attention

exertional chest discomfort is classic but just all too often ignored by athletes who simply think it can't happen to them....


It is critically important to never ignore serious warning symptoms. These can occur in common or unusual ways. https://www.heart.org/...ns-of-a-heart-attack

Pain which occurs due to inadequate blood supply to the heart muscle itself is called ‘angina’. Typical angina is described as an exertional chest discomfort/tightness/pain which may radiate to the neck/jaw/back or arm and can be associated with nausea/vomiting or sweating. That is exactly what Mr. O’Donnell had and even he knew it might be a heart attack but questioned it because of his excellent fitness. Angina usually occurs with activity and stops with rest but if it doesn’t stop, it can be the start of a heart attack and people should get checked out immediately. Atypical angina, which happens more frequently with women, is different and more often involves activity limiting shortness of breath, isolated neck/jaw pain/arm pain or fatigue.

Risk is higher with a poor diet, inactivity or with high cholesterol (especially elevated LDL). It is also higher if a patient has hypertension or diabetes. These are the traditional ‘risk factors’ for heart disease which people talk about. There are also ‘Risk Calculators’ available that are frequently used with a patient’s age, cholesterol and BP numbers to give additional information about future cardiac risk. You can modify behavior but you can’t change your age or genetics. https://tools.acc.org/...!/calculate/estimate

The take home message is really twofold: 1) if you have any concerning activity limiting symptoms, then you should be evaluated quickly by appropriate medical care providers and 2) CAD is widely prevalent and anyone (*over 35) can have a heart attack, even if you are very active and fit. So be smart and obey that little voice in your head when it says to you “hey, something is just not right” and get checked out. It could cost you your life if you ignore it.

Reasonable screening for risk factors for CAD should include: BP check, fasting bloodwork-checking lipids/kidney function/electrolytes and blood sugar, history/physical exam and sometimes an EKG.

Aggressive screening for CAD may include: EKG, stress test (with or without imaging) CT of the chest or coronary artery calcium score (CACS). CACS looks for any plaque buildup and is a very quick, easy, relatively inexpensive non-invasive test that can tell if the process of CAD has begun or not.

People with intermediate/high risk symptoms or testing often require a coronary angiogram or cardiac catheterization. This is a procedure done to see exactly how blocked up the arteries are and treatment can be given immediately for critically narrowed arteries with a balloon dilation procedure and a stent to deliver better blood flow in the long term. Some people with multiple critically narrowed arteries need open heart surgery with coronary artery bypass grafting (CABG).

To those out there who want to be checked, consider talking to your own doctor about coronary artery calcium scoring and making sure your own risk factors have been checked appropriately. Stay well.

The OP does not need a coronary calcium score-he has KNOWN CAD.

D.Toce MD FACC
(aka dtoce here on ST)

you asked--here are my thoughts:
https://www.slowtwitch.com/...art_Health_7911.html


info on coronary artery calcium scoring:
https://www.acc.org/...-cardiovascular-risk

Sudden death in triathlon:
https://forum.slowtwitch.com/...riathlon_P6427784-2/

another thread after T. O'Donnell's incident
https://forum.slowtwitch.com/...rt%2C%20cad#p7579078

Great advice

Coronary calcium score only costs a couple hundred dollars even with zero insurance

Takes not a few minutes and non invasive. Super simple

IMO something which everyone should have as they age

I wish Drs would recommend this more especially for people with know symptoms

In search of the righteous life... we all fall down
Quote Reply
Re: Lucky to be here [ckoch] [ In reply to ]
Quote | Reply
Your sig is fantastic!

Thanks
Quote Reply
Re: Lucky to be here [TriBiker] [ In reply to ]
Quote | Reply
Glad you survived the cardiac event. Keep us updated as to how you are.

maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD
Quote Reply