vonschnapps wrote:
Absolutely agree. The article did mention 29% as having the underlying condition leaving 2/3 of those having no previous symptoms. I have to admit it’s been on my mind before the start of the swim in every race this year and have altered my start to gradually build up speed and keep my heart rate down. A few years ago we had a rash of deaths in the swim and there were some good efforts in discovery of potential causes as the article mentions, I’m hopeful for continued studies to give us a better idea of what’s going on in those cases where there were no advanced warnings.
The pathophysiology of an Acute Myocardial Infarction does not require symptomatic coronary artery disease. A rapid increase in blood pressure at the swim start may be responsible for a small tear in a tiny fragile cholesterol plaque resulting in a platelet thrombus (clot). Damage to even a small amount of myocardial tissue can cause an arrhythmia. Endurance athletes are at higher risk of atrial fibrillation, and I suspect other heart arrhythmias. All of these conditions are more common in Older athletes. The primary variable in successful CPR is “time to shock.” Defibrillation is treating the potentially fatal arrhythmia, not the infarction. In open water, that is problematic. My response is to ease
into the swim... even if I have warmed-up throughly. The fact is that a well-trained older adult is far less likely to die on any given day than one who is watching from the sidelines ;-)