Warm up good before the race, and just stay within yourself at the beginning. Nothing wrong with getting check ups, but I would guess just about every swim triathlon related death would have had a clean bill of health right before the race. And do lots of OW swims in practice, get really used to the feeling so that it doesn't compound your anxiety during a race. We all get it, just how you deal with it..

Hell, I was near death because of a heart condition, went to the emergency room TWICE, and they sent me away saying there was nothing wrong. Those 15 second or so EKG strips are often useless for a lot of ailments with the heart. If you are training and racing all the time, you are probably fine, just get your check up and try and not worry about it too much. Get lots of sleep, dont stay out all night before drinking with buddies, and keep the moving coffee at your normal levels..

I'm 34 and worry about this too. I've had some weird chest pains come and go over the past few weeks (not during workouts). I've never had any chest pain or discomfort ever during a workout or race so it is unusual. I'm going to see a doctor next week who does endurance sports to get a full heart workup to make sure I'm okay to keep doing this. I have gone pretty deep into the well during a few races so I wouldn't be surprised if there is an issue.

This has happened to me twice now,once in the 90's and once during Ultraman Oz last year. I managed to actually get through the whole of day one in May last year feeling very sick and the nurse on my crew was very concerned.Stupidly I started day two and after about an hour the race staff found me on the side of the road in a very bad way.In the emergency ward of the Noosa Hospital a couple of hours later the Doctor in charge (also a triathlete) was treating me for pulmonary oedema and said "right now I am trying to stop you from having a heart attack".Just something to think about.
( I have been doing Ironman since '91 and Ultra Triathlon's since '94)
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http://www.endurancetriathletes.com/sipe.html

I was at the race this year. I was a few minutes behind this poor young man. By the time I got to the beach he had already been taken away in the ambulance. But my family who had been waiting to cheer for me, saw the whole thing. It has been weighing heavily on me. I’m 41 now. Am I being a responsible parent by participating in these events? Am I doing everything I can so I am there for my kids?
Back to the OP. I’ve had the paper ekg thing, and it is very unsatisfying. If I went to the doctor tomorrow what should I ask for? Blood work? What am I looking for? A stress test, like an ekg on a treadmill? A cardiologist? But I don’t have symptoms. Is undiagnosed Afib the most common cause in swimming deaths? Or is it just unknown?

I know there are hippa issues here, but I would assume all of these deaths are investigated. Is there any common cause? If undiagnosed afib is a common issue, I feel like it should be talked about.

It looks like the water was pretty cold this year. I could see that being a contributing factor.

I went to my doctor when I first started training and racing because my mother has mitral valve prolapse. I wanted to make sure everything was good to go before racing. They ended up having me do a stress echo where I ran on a treadmill and monitored my heart. I was cleared and good to go for racing. I am still very cautious though. I practice OWS often, visualize race situations, force myself to start a swim slow as everyone around me hammers. From my basic research it seems genetics, adrenaline, anxiety, and intensity are the factors.

I was volunteering at this race as a course marshal at an intersection. I heard the EMS call go out over the police radio for it. I knew something bad was up because almost every time someone has a "minor problem" in the swim, they just pull them out and that's the end of their day. But when I heard EMS called down to the beach, I knew it was bad. It happened not far from where I was stationed but fortunately not where I could see as it was on the other side of a dune. I have had my share of that already having been part of the rescue of a racer who collapsed on the run course at Lake Placid 70.3 last year.

I am 38, in good shape and usually at the top of my AG in bigger races, but I still wonder if something this going to happen to me when I am out there racing. Every one of these incidents I hear about is always someone in decent shape. It's rarely someone doing their first event, or is in the process of getting back into shape or whatever. I guess I could go see a doctor to do a checkup but I honestly am not sure what they might find. Did these guys that had cardiac issues in a race recently have doctors check them out and say they were fine?

There is this: https://www.docdefib.com/...ause-cardiac-arrest/

Factors include quick immersion into cold water, anxiety about the event, elevated respiration, elevated heart rate, elevated stress response, warm-up time, and a few others.

I was a spectator at Boulder 70.3 in 2018. I saw an ambulance at the swim finish. I think I’ve forgotten what happened, but it was an emergency in the water.

I have to admit that this thread gave me a chance to evaluate my own swimming. I don’t do triathlons anymore, and don’t often run or bike, so swimming is my exercise. I’ve recently swam in a major American river without a wetsuit (but towing a buoy). The first time this year, the water was 73 or so, which meant that I jumped in and felt the cold pretty quickly and had to remind myself to breathe. I swam in an outdoor pool yesterday, temps around 77.

I can tell myself this while I drink my morning coffee, but “at least I’d go out doing something I love.” I hope I don’t have those few seconds after my heart stops to wish I’d take that sentiment back. Frankly, in my current state of mind and mood, I’d probably welcome it....

I feel like there would be a tremendous cost of teaching your kids to be afraid of everyday activities. My neighbor dropped dead playing with his kids in the back yard (father of sextuplets). These things are unfortunate, but people die doing all sorts of exercise. In the end, exercise is much more likely to to extend your life than shorten it.

I did the race this past weekend. Very sad to hear this news.

I was concerned about cold temps but it was not an issue for me. I emptied a few water bottles inside my wet suit just before I went in. I heard that helps. Chop was very light.

I just happen to have scheduled an annual doctors appointment for today- so I intend to discuss this with him. He is an athlete so I feel like he understands the question.

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Dan Kennison

facebook: @triPremierBike
http://www.PremierBike.com
http://www.PositionOneSports.com

I saw 50's man looked pretty healthy collapsed and passed out on the run during Olympic race in Austin, TX last week. Three guys were already helping him, so I passed by, but if the same thing happens to him during the swim, he could have been in very dangerous situation. It was scary. I bet he didn't know that would happen to him before the race.

IMO

Races put extreme stress on the heart and what might have never been an issue, suddenly is when the heart is pushed to the extreme. So many people have non-diagnosed conditions that otherwise might not have caused issues. They just never felt bad, so why get the extra tests? We had a guy here in Kansas City die after a half marathon. He had run many before and it was routine for him, but he had a condition revealed after examination that needed attention in order for him to continue his running without issues.

I always recommend my athletes request a yearly EKG from their primary care. Most can do it in their office. You have to have a sharp primary care that understands endurance training and what you are doing and why you need the test for insurance. The tricky part is having the primary care be savvy enough to warrant an electrocardiogram as a follow up from the EKG as the EKG only tells part of the story. The echo is the real reading that will show any underlying issues. It helped my primary raced half ironman tri's, so she knew exactly what I was after.

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Ryan
http://www.SetThePaceTriathlon.com
http://www.TriathlonTrainingDaddy.com
I got plans - https://www.trainingpeaks.com/...dotcom#trainingplans

I'm not a doctor and I have never played one on TV, however I just had a pretty comprehensive exam and wanted to share my experience here for any insight it could provide or contribute to the conversation.

Since I work as an airline pilot I have been having routine ECG's since I was around 29 (now 41) From the very first one I ever did the doctor said it's not normal and you need to go see a cardiologist. Cardiologist examined me at that time using an echo (ultrasound) and said your heart is perfectly fine. He said ECG's can be unreliable. I wasn't a triathlete at that time and was very out of shape. The visit to the cardiologist and his subsequent report made my non-normal looking ECG's from that point forward a non-issue. Doctors always said "your ECG isn't normal, oh I see you saw the cardiologist, ok no problem"

Fast forward to this past December. Back to see the doctor for routine pilot medical exam including the ECG. Doctor says it's not normal looks at my cardio report and says the report is getting old and the aviation regulator is getting more strict. He tells me to go see the cardiologist again to get an updated report when I have some free time. Well I didn't have any free time as I was training for IMTX so I put it on the back burner for a while and figured after the race I will go. In the lead up to the race I read about the 2 guys down at IMSA. I read the ST forum thread about it and I read Monty's story about how he had some issue during a race. Out of nowhere I start to become super paranoid. No clue why but I am paranoid as all get out about the swim. Long story short I decide to swim stupid slow for the first 1/3 of the leg and just focus on staying alive. Swim goes fine and I pick up the pace a bit as planned. No issues.

But after this unexpected bout of paranoia I decide the first thing I am going to do after the race is get that referral out from my pilot doctor and go see the cardiologist again. So I did it all and have just translated the report from doctor gobbledygook language. Here's what they did and what it cost.

1) Visit to doctor with referral, he knows I have an electrical system in my heart that doesn't fire like most hearts should, he also knows I have an abnormally low resting heart rate of 48.
2) he does another ECG for himself
3) he does another echo (ultrasound). this seems pretty thorough and takes a while
4) they wire me up to another electrical harness and throw me on the treadmill while plugged in to do a stress test (bruce protocol)
5) Lastly they wire me up to a holter monitor for a 24 hour ECG.

Total cost 1700 USD. (paid for by insurance/work)
Summary: normal echo, exercise stress test negative for heart attack, 24hr holter says no fast or slow arrhythmia.

I feel a lot better given all the heart talk around here these days but a comprehensive exam is really expensive.

Just raced in an event, the "Wisconsin World Championships" and had a guy in my wave die. Had a "medical event" prior to going under and personnel got him out quickly. A friend was standing next to his wife when she realized, so not a good scene. He said they were prepared, and used everything they could but he didn't make it. He was 59, and was an OB-GYN Doc. While we all feel for family and all of us are touched, sometimes it's time. Embrace every minute you've got, do your best to shunt the odds in your favor, but live. More die on the couch than in the water....

Story here.....https://wkow.com/...riathlon-identified/

I was there at Lake Mills on Sunday as well, but was in an earlier wave, so missed the accident. It is a shame. My support crew who were there saw it all and were pretty shaken up afterwards. My thoughts go out to his family, particularly those that were there to support him.

Allow AG athletes to warm up in the water before the race for one. St. George 70.3 didn't allow it and were threatening anyone that was in the water with a DQ.

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Instagram or twitter me softly @xatefrogg

Yea, as it was in my wave I had no idea, but had chatted with a lot of the old chaps before the race. That is far too young, but we recounted the number of our acquaintances through the years that have passed doing what they love and feel we'd rather that than another way. It's never a good time and as this person was a doctor, I would have thought he knew symptoms. Sometimes one cannot prevent these things from happening and knee jerk reactions are seldom good. I'll treasure each time I toe the line a little bit more now.

1) Visit to doctor with referral, he knows I have an electrical system in my heart that doesn't fire like most hearts should, he also knows I have an abnormally low resting heart rate of 48.
2) he does another ECG for himself
3) he does another echo (ultrasound). this seems pretty thorough and takes a while
4) they wire me up to another electrical harness and throw me on the treadmill while plugged in to do a stress test (bruce protocol)
5) Lastly they wire me up to a holter monitor for a 24 hour ECG. //

Good job there Aaron, getting tests does give you peace of mind. But none of these really tells you about your blockage, if you have any. All he stress echo does is point out that you are not more than about 75% or so blocked. Not a great deal of accuracy there, so I would also suggest you get a calcium scan to add to your list. Insurance doesn't pay for them, but they are like a $150, so not a big deal, and it only takes about 20 minutes. Get a good baseline started, and then you have something to compare to in the future. My doc said these are not conclusive either, but with all the other tests in hand, if they all point you in a bad direction, then time for the more accurate tests. So it is kind of a test to just put your mind more at ease I suppose, but also tell you if you are in the 79% of blockage and had no idea...


And 48 is not an abnormally low rate, pretty normal for athletes. Now my 28, that was abnormally low, but normal for me...

Do you have heart issues now? I apologize if o missed that already. If so, do you think year’s of endurance training played into it?

Thanks!

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https://twitter.com/mungub

Bet the price is cheaper than a funeral...

Not sayin, just sayin.

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Ryan
http://www.SetThePaceTriathlon.com
http://www.TriathlonTrainingDaddy.com
I got plans - https://www.trainingpeaks.com/...dotcom#trainingplans

I got a pacemaker in 2001 for 3rd degree heart bloc, and I feel I did the damage racing and training while sick a few times. As a pro, I just had more incentive to cross that line, and of course coaches in my day just told you to suck it up buttercup. I have since fixed most my heart problems, with attention to all the risk factors, and toning down my ambitions, and of course never doing anything while sick..

Thanks for posting TravelingTri. Sounds like you have a good doctor. Good luck with your racing. There have been suggestions of further testing just remember that all tests have errors inherent in their methods both false positive and false negative. That can lead to unnecessary riskier tests/proceedures if prone to false positives. I'm sure your doctor has considered the balance vs risk equation based on your (good) results and you're good to go.

Thanks Monty I hadn't ever considered blockage also. They are doing blood tests each year for cholesterols etc which are always well within normal. But I am pretty certain I could get a free calcium test as well so I will give it a shot at my next exam. I am not certain all the standard for heart rate and aviation but I am pretty certain around here anything below 50 has to be investigated no matter the circumstances.

Mungub50, no I guess I don't have any heart issues now nor in the past, even before triathlon. My ECG is always showing bundle branch block or sinus rhythm or something else, but when investigated I am always considered "normal". I have never had one
cardiac related symptom.

Mark57, thanks and I agree about the difficulty of testing and information. I had this exact situation with someone close to me. This person was getting some AFIB symptoms so I think it was a heart catheterization as part of the testing and next thing you know blood clot in their leg. YIKES! The test results were inconclusive as to what the issue was and after a while the heart went back to normal functions with no complaints but the treating of the blood clot went on for a long time.

Sure some deaths are preventable and others not. People have heart attacks all the time, while open water swimming is an awful time to have one... the statistic in the US is one every 40 seconds. I had two friends die of heart attacks in the last year... one was eating Thanksgiving dinner with his family, the other was driving had a heart attack and crashed. Both died within a week in an ICU setting. Both of my friends I would put in the high risk category... I wasn't super surprised they had heart attacks.

Most of us here are in the low risk category given we exercise, eat healthy, etc. Even then it can/does happen... I'm not a doctor or medical professional but as I understand it some have genetic predispositions or conditions that can contribute to heart issues even with "healthy people".

Things can and do happen... I say if you're worried about it, get checked out.