Login required to started new threads

Login required to post replies

Chicago Marathon Death, Heart Defects
Quote | Reply
I've been following the news on the young lady who unfortunately died immediately after she finished the Chicago Marathon last week. Apparently, although it's not official, there is now mentioned she had a problem related to her left heart valve.

http://www.canada.com/...A4-84E0-34DE9C12BF20

I guess my concern is, even if you are in super shape and do Ironmans or half Ironmans, how would you know you have a heart defect, or have a potential pulmonary embolism set to go off, if your blood pressure is normal and you have no obvious high risk criteria?. EKGs are expensive, and I'm not sure if your carrier would cover them, preventatively, without some immediate problem in coronary disease surfacing, prior to a race. And will EKGs or stress tests really show or detect these aberrant cases?. Although there is massive amounts of support for the fact that getting in great shape greatly reduces coronary disease, there seems to be some evidence, that doing endurance racing, might trigger the defect or problem.
Quote Reply
Re: Chicago Marathon Death, Heart Defects [boothrand] [ In reply to ]
Quote | Reply
I believe the test that would be done to look for a heart valve problem is called an echocardiogram. You wouldn't normaly have this done unless there was a problem or suspicion of a problem, such as family history.
Quote Reply
Re: Chicago Marathon Death, Heart Defects [boothrand] [ In reply to ]
Quote | Reply
I broke down last month and had a cardiologist give me a treadmill stress test with a radioactive injection. They take pictures before, make you work, give you an injection while you are working, then take pictures after.

I have a slight arrythmia (sp?) that I used for the "reason" to get the test. Insurance covered it.

A few years earlier I paid for a heart scan. They stick you in a CAT scan unit and measure the calcification in four major arteries. I am not sure that test is really valid since it is not calcifications that kill you, it is plaque, but hopefully they tend to track.

I don't know if the stress test would pick up a heart valve problem. I would guess not.

It never hurts to get yourself checked out once in a blue moon. Lots of very active, fit people drop dead from preventable causes. Don't be one of them.
Quote Reply
Re: Chicago Marathon Death, Heart Defects [ajfranke] [ In reply to ]
Quote | Reply
Well, it's not really the plaque that kills you, either...it's the blockage of blood flow in the coronary that either sets up a fatal arrhythmia due to ischemia, or kills enough heart muscle (again, due to ischemia) to do the job. Plaques can erode and rupture...sending your platelets into their clotting cascade mode which can cause the killer clot to form fairly quickly, or, plaques can just slowly get bigger until the lumen of the artery is compromised enough that platelets stick at the site of narrowing and turbulence and form the killer clot.

The thing is, there isn't any foolproof, cheap way of detecting these problems...depending upon how you define cheap. If 50,000 dollars is considered to be cheap when you are talking about your LIFE, well, then it IS cheap, because you could have every test in the book done for well less than half of that. If you think 500 is expensive when talking about your LIFE, then, yes, it isn't cheap.

Stress test can catch almost any problem, bad thing is, they can miss many problems. Most people that have exercised for years have the benefit of doing their own version of a stress test every time they go for a run...feel tired? out of breath? any chest pain? any unusual blips on my HR monitor cadence? nope? Then you just passed your own stress test.

The problem with EKG's is they don't catch some problems until there is a significant problem already. MRI's with the calcium scans are more expensive, but don't catch all the glitches either. You really don't want a cardiac catheterization as a "just fishing" test, because it has potential to cause the very clots and dissections that a diseased vessel is subject to. Echocardiagrams are the least invasive, and can tell a good bit about heart function...especially of the valves...but, you don't really want the "Best" trans-esophageal echo unless the trans-thoracic one picks up something than needs closer scrutiny, because the trans-esophageal involves swallowing a catheter that's about the size of a blacksnake...and they generally do it when you're awake.

Furthermore, pulmonary emboli aren't something that is generally caught by any of these tests, because Pulmonary emboli are usually from a clot originating in the leg...it breaks loose, goes up the Inferior vena cava and then the right heart and out to the pulmonary vascular bed where the embolism lodges...and may kill you. That's right. Sitting for a long time in the car after a hard workout or race can kill you if a clot forms in your leg, breaks off when you get out of the car, and you're dead pretty quick...or at least in a great deal of discomfort for a while, or maybe you don't notice it much if at all...it depends upon the size of the clot and where it lodges.

As far as the woman with a bad "left valve"...well, there are two "left valves", the mitral and the aortic.

Look, if you are a very active triathlete, don't have any heart related symptoms, eat right, don't smoke or take drugs, get enough rest, and DON'T EVER sit in a car or plane for a long time immediately following working out hard...you've got a MUCH greater chance of getting killed while riding your bike than from some undetected heart disease.

Heart disease? It happens. It IS the Number 1 Killer in the US....but, it's not the number 1 killer of triathletes. Keep moving....and be careful out there....especially on your bike.



Quid quid latine dictum sit altum videtur
(That which is said in Latin sounds profound)
Quote Reply
Re: Chicago Marathon Death, Heart Defects [davidblaine] [ In reply to ]
Quote | Reply
wow, this hits close to home. i've known for as long as i can remember that i have a heart murmur (ie, a valve problem), but my doctor, upon finding out that i've increased my race durations from short 5k's to 1/2 IMs, told me to get tests done. i went in last week for an ekg and an echocardiogram (the thoracic version, thankyouverymuch), and i'm still waiting for the results.

it was a great experience, both in that i'm curious about medical things, and in that my heart is apparently very powerful (as much as any of yours are, i'm sure, but definitely stronger than joe sixpack's). my resting heart rate is 47 bpm, and while i could barely figure out what was going on in the echo test, the technician said that my ventricular contractions were "impressive".

so yeah, i'm pleased with my cardiovascular shape, and i know that i'm going to improve it even more over the next few years - unless the results from my tests come back positive (or negative, i'm not sure - whichever means i have to stop running). seriously, i don't know what i'll do if all of a sudden i have to stop being a triathlete for fear of dying like the lady in the original thread.

wish me luck, i guess.




http://www.theninjadon.blogspot.com

"The bicycle riders drank much wine, and were burned and browned by the sun. They did not take the race seriously except among themselves." -- Ernest Hemingway, The Sun Also Rises
Quote Reply
Re: Chicago Marathon Death, Heart Defects [vidaeboa] [ In reply to ]
Quote | Reply
This is another problem of heart disease diagnosis. Sometimes, an "impressive" ventricular contraction signals a very fit heart. That's probably your case.

Other times, it is a hypercontractile ventricle that shows up in an early compensatory stage in someone with aortic valve disease...although an athletic heart generally has a thicker wall, a heart that is beginning to change because of Aortic stenosis has an even thicker wall...and we're not talking about much difference here.

But the athletic heart is only under a bigger workload for a short period during the day...the workout. A heart that is battling against a stiffening bicuspid aortic valve (which can cause a murmur during systole) is under increased workload EVERY beat of the day...big difference. A big problem with this ventricular thickening is that the further heart muscle tissue is away from the blood vessel that supplies it, the more likely that muscle tissue is to experience ischemia...so, thicker-walled ventricles are more likely to experience subendocardial ischemia even from a small clot, which can trigger the arrhythmias that can kill you.

You can really know too much about this stuff if you tend to be a worrier. Then again, if you simply need hard test data (even if it doesn't guarantee anything!) to move on with your life...go get tested. Only you can determine if it is expensive...it depends upon your hypochondriac titer, insurance, personal wealth, history, etc.

Good luck with your test results. I'm hoping it is just something like a mild Mitral regurgitation or prolapse, and that you won't have to curtail any athletic participitation...but, make sure you take prophylactic antibiotics when you go to the dentist...it helps to prevent subacute bacterial endocarditis, which can REALLY screw up your heart valves, among other things.



Quid quid latine dictum sit altum videtur
(That which is said in Latin sounds profound)
Quote Reply
Re: Chicago Marathon Death, Heart Defects [yaquicarbo] [ In reply to ]
Quote | Reply
Queston? I have HR at times that goes to 235. Other times slight pain while running so in I went(I am not asking any medical advice here)So anyway they hooked me up to a soni-gram,ultrasound device. Pretty cool pictures of my heart. Had me do a stress test then looked at the pictures at a 168hr. Again pretty cool. Measured the size of the chambers contracted and expanded ect.. Determined that I have an electrical problem and now I am wearing an event recorder. Here"s the question. Is not this a fairly cheap and accurate test(though I have not seen the bill yet).
Quote Reply
Re: Chicago Marathon Death, Heart Defects [Kenney] [ In reply to ]
Quote | Reply
All these tests are decent, it's just that all of them have their respective limitations, and considering the alternative, I think they are all cheap. But, I value my health very highly, and don't look at good health as a right; I look at health as an irreplaceable gift to be cared for above most other things...especially a little sum of money. Without money, you do without things until you can make some more money. Without health, no amount of money in the world will suffice.

The ultrasound you had is a remarkable tool, isn't it? No discomfort, you get to see the structure of many important parts of your heart, they use doppler technology to determine blood flow through chambers and across valves, all pretty cool stuff. What you're telling me is that they couldn't detect anything structurally that would show why you would be having a dysrhythmia. Now, they are trying to find out what that abnormal rhythm is, to put a name on it. Especially, they want to know if your abnormal rhythm is rhythmic, or arrhythmic.

This monitoring system could very easily find out what your dysrhythmia is. It won't find out the cause, though, and you may or may not ever find out the cause. You and your doctor will have to decide whether or not finding the exact cause is important enough to you to keep on digging. Depending upon the findings, you may find a "cure" in your eating, drinking, and sleeping habits. Really, it can be that simple. OR, it could defy almost any test but actual physical mapping of the heart muscle itself.

Good luck, usually these things aren't a really big deal in people that are active when no structural abnormalities are present...which probably accurately describes you.



Quid quid latine dictum sit altum videtur
(That which is said in Latin sounds profound)
Quote Reply
Re: Chicago Marathon Death, Heart Defects [Kenney] [ In reply to ]
Quote | Reply
I have the same thing (arrythmia). Had stress tests - no arrythmia triggered. Went something like 4 levels higher than the test protocol called for - nothing. We only stopped because I hate treadmills and was bored out of my skull. Wore a holter monitor for 24 hours, then 48 hours - no arrythmia triggered. Had ultrasound - nothing but a cool pic of my heart. Doctors didn't follow up.

My new doctor (moved to a major centre) has sent me for a pile of tests to figure out what it is once and for all. Her only other tip for me was to pretend you were trying to, ahem, 'poo' when the arrythmia hits, as this will usually end it instantly. It seems to work more consistently than coughing, which I used to do to end it.

Sooo, the tests are accurate but might not tell you anything. How old are you? Have they ruled out WPW as a possible cause?
Quote Reply
Re: Chicago Marathon Death, Heart Defects [Marlin] [ In reply to ]
Quote | Reply
Thanks to both of youfor repling. I am 44. Had this the first time at 15. Happened at the last to races. In a sprint tri during the swim,very uncomfortable,hard to swim. Then at the 20 mile mark in a marathon. After 5 min, it stopped (by bearing down)and off I went. There has been a couple of times that it went on for an Hr. Very uncomfortable.Might happen twice in a week then not again for two months. Always was told not to worry,however when it happened during the last two races a couple of Doctors that were competing said that being in my 40's it was time to get an answer to what it is. So thats what I am doing. By the way Yaqui I completely agree with your view on health. It is a gift. After I completed IMCDA my thought was not my time but thankful that I have the health to compete an event.
Quote Reply
Re: Chicago Marathon Death, Heart Defects [Marlin] [ In reply to ]
Quote | Reply
Hey, Marlin...if you don't like to say you are trying to "poo", just say you are doing a valsalva (say it like this: val-sal'-va...all a's sounding like the "a" in "at") maneuver. It sounds more impressive, but it's talking about the same "bearing down" technique...



Quid quid latine dictum sit altum videtur
(That which is said in Latin sounds profound)
Quote Reply
Re: Chicago Marathon Death, Heart Defects [yaquicarbo] [ In reply to ]
Quote | Reply
Definitely better than 'pinching a loaf'...
Quote Reply
Re: Chicago Marathon Death, Heart Defects [boothrand] [ In reply to ]
Quote | Reply
As a "lab rat" for a well known sports drink manufacturer, I was required to take a stress test every year. You know, the kind where they stick wires all over you and try to kill you on a diabolical treadmill. They didn't really have a chart that included my age (59), but the test results usually indicated that I was a very fit 35 year old.

I asked the cardiologist if these results meant that I won't drop dead during my next marathon. He gave me the same kind of answer that you have seen above: "No, not necessarily." Clearly my years of endurance training have put me in a much healthier and lower risk category than my sedentary colleagues, but I don't think there is a "gold standard" test or series of tests that will give a definitive answer.

David
Quote Reply
Re: Chicago Marathon Death, Heart Defects [glider] [ In reply to ]
Quote | Reply
The way I look at it is this...being in good shape may help me live longer, and it might not, and that's just fine. However, being in good shape makes my quality of life MUCH better while I'm here...and that's enough for me. People can worry themselves silly about longevity, the fact is, if you study health in depth at all, you'll find more ways to die than you ever thought possible...and they are ALL possible. Be prudent, be vigilant, get suspicious things checked out, then get out there and live life to the fullest.

My Grandfather used to joke that he'd have taken better care of himself if he knew he was going to make it into his 90's (I'm not sure who he stole that line from, but it was Grandpa's line as far as his little grandson believes!)



Quid quid latine dictum sit altum videtur
(That which is said in Latin sounds profound)
Quote Reply
Re: Chicago Marathon Death, Heart Defects [yaquicarbo] [ In reply to ]
Quote | Reply
i'd like to thank you for all your information and your reassuring words. whether or not you meant to, you kept me from flipping out while waiting for my results. i just received them this morning:

"The results of your echocardiogram was normal. NO valve abnormalities, normal pumping function."

i asked the doctor for some quantitative data, or some pics/videos/sounds of my heart from the test, because i am a biomedical engineer and inherently curious about this sort of stuff. truth is, though, i'm just glad to know that i can keep pushing the envelope.

thanks again.





http://www.theninjadon.blogspot.com

"The bicycle riders drank much wine, and were burned and browned by the sun. They did not take the race seriously except among themselves." -- Ernest Hemingway, The Sun Also Rises
Last edited by: vidaeboa: Oct 18, 03 12:38
Quote Reply