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Racing with LAD Blockage
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So I just got hit with a whammy while going through the life insurance process. Apparently I have a "Left Anterior Descending Artery Abnormal 3.3cm Calcified Plaque with 25%-49% stenosis.". Dr. Google tells me this is called the "widow maker". I did see a cardiologist during recovery from COVID last year and I do continue to have issues. I had multiple scans and test run on my by the cardiologist and was told that nothing was wrong with me at all.

Enter USAA

I was quoted at $60/mo for the coverage and they came back and said they would cover me, but for $300 a month because I was a heart attack risk despite all of my other testing coming back perfect. For the insurance company to raise my rate %500, I am starting to think that I should get a second opinion.


That brings me to my question. Is it stupid to train and race with this condition? The cardiologist said I was good to go a year ago and didn't mention a single thing about this blockage.

I am frustrated and, frankly, a bit scared - wondering if there is anything I can do about this.
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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See a cardiologiest immediately.

Had a recent scare, had an x-ray done (for a nagging rib bruise issue) and it showed a potential "enlargement" of the heart. Dr. Google was telling me I was going to die. Doubly paniced because I had WPW and open heart surgery decades ago to correct it. The panic was...well bad.

Made an appointment with cardiologist had a ultrasound done. Inconclusive.

Then had an MRI scheduled. Cardiologist called and said everything was fine.

But for two months I backed everything way down. Psychologically I couldn't go hard even when the doctor's said I was low risk. It wasn't until I got the clean bill of health that I could go back to not being rate rate obsessed with every flight of stairs.

Only a cardiologiest (or two) can tell you for sure.
Last edited by: opusTpenguin: May 12, 21 7:48
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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LifeTri wrote:
So I just got hit with a whammy while going through the life insurance process. Apparently I have a "Left Anterior Descending Artery Abnormal 3.3cm Calcified Plaque with 25%-49% stenosis.". Dr. Google tells me this is called the "widow maker". I did see a cardiologist during recovery from COVID last year and I do continue to have issues. I had multiple scans and test run on my by the cardiologist and was told that nothing was wrong with me at all.

Enter USAA

I was quoted at $60/mo for the coverage and they came back and said they would cover me, but for $300 a month because I was a heart attack risk despite all of my other testing coming back perfect. For the insurance company to raise my rate %500, I am starting to think that I should get a second opinion.


That brings me to my question. Is it stupid to train and race with this condition? The cardiologist said I was good to go a year ago and didn't mention a single thing about this blockage.

I am frustrated and, frankly, a bit scared - wondering if there is anything I can do about this.

Go see a cardiologist now. Do not pass go, Do not collect $200
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Re: Racing with LAD Blockage [opusTpenguin] [ In reply to ]
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opusTpenguin wrote:
See a cardiologiest immediately.

Had a recent scare, had an x-ray done (for a nagging rib bruise issue) and it showed a potential "enlargement" of the heart. Dr. Google was telling me I was going to die. Doubly paniced because I had WPW and open heart surgery decades ago to correct it. The panic was...well bad.

Made an appointment with cardiologist had a ultrasound done. Inconclusive.

Then had an MRI scheduled. Cardiologist called and said everything was fine.

But for two months I backed everything way down. Psychologically I couldn't go hard even when the doctor's said I was low risk. It wasn't until I got the clean bill of health that I could go back to not being rate rate obsessed with every flight of stairs.

Only a cardiologiest (or two) can tell you for sure.


I did see my cardiologist about this months ago and that is where the insurance company got this information. The cardiologist did all of the tests you mentioned and more.

I think I should get a second opinion. Anyone have a good cardiologist they can recommend in the Philadelphia area?


Like WTF does this stuff even mean:

  • CAD-RADS 2
    • consider evaluation of non-acute coronary syndrome etiology, if normal troponin and no ECG changes
    • consider referral for outpatient follow-up for preventive therapy and risk factor modification
    • if clinical suspicion of acute coronary syndrome is high or if high-risk plaque features are noted, consider hospital admission with cardiology consultation

  • CAD-RADS 2
    • no further cardiac investigation
    • consider non-atherosclerotic causes of chest pain; consider preventive therapy and risk factor modification, particularly for patients with nonobstructive plaque in multiple segments

Last edited by: LifeTri: May 12, 21 7:56
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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Have a friend who recently recommended Neel Chokshi at Penn Medicine, who has a focus on exercise/athletics (friend had come to Philly to see him for second opinion/further diagnostics after having been to a cardio who was not sports focused).
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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Dude... no answers for you but... sorry to hear this
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Re: Racing with LAD Blockage [g_lev] [ In reply to ]
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To say I am furious that my cardiologist did not mention this to me is an understatement.

I believe his language was, "You don't have any blockages that would be out of character for a western white male your age."

Like, its on me for not catching that nuance now that I look back on it. But sheesh, I am not a 3 big mac a day kind of western white male.
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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I am not a medical doctor and this is outside my scope of practice as a sport phys guy, so please take this as peer to peer discussion.

I would personally do 3 things. These are not recommendations. Just what I would personally do in your exact position:
  1. Reduce exercise intensity until further notice.
  2. Contact current cardiologist and request detailed phone discussion or virtual appointment and ask lots of hard questions. I would not let the conversation end until satisfied I had gotten all answers to all questions.
  3. Contact new cardiologist with endurance sport experience and get second opinion, ideally asap, but after the first cardiologist convo, so that I could cross-check cardiologist #1 answers with cardiologist #2.


Dr. Alex Harrison | Founder & CEO | Sport Physiology & Performance PhD
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Re: Racing with LAD Blockage [dand] [ In reply to ]
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I just got off the phone and have an appointment set with the good doctor. Dude seems like he knows whats up.

https://www.pennmedicine.org/...profile/neel-chokshi
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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LifeTri wrote:
To say I am furious that my cardiologist did not mention this to me is an understatement.

I believe his language was, "You don't have any blockages that would be out of character for a western white male your age."

Like, its on me for not catching that nuance now that I look back on it. But sheesh, I am not a 3 big mac a day kind of western white male.

sorry to hear, hope you get this under control.

Unfortunalty, "western white male" is a terrible yardstick. look at the levels of heart diseases, metabolic diseases, etc. in our country
beyond what was already said, I would recommend looking at your diet. I know its a religious topic, and there are tons of threads here on this topic, but I think its quite acceptable fact that the "Standard American Diet" is correlated to health issues (not saying that is what you are eating, just raising another point to think about)

good luck.
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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what testing did you have in the first place to determine you had a "25-49%" stenosis(CT?), and why was this testing done? I ask because if you weren't having symptoms, this may be a case of ignorance is bliss. "routine" screening isn't for everyone, and when people go looking for things without a necessarily good reason, the outcome can be more harm than good. did insurance request this testing?
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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I’d wait to get your second opinion before getting too much more bent out of shape. Dr Google can cause lots of anxiety. Assuming your first cardiologist is decent he would have understood all the testing and gave you a fair recommendation.

The wording you are listing appears to be a fair bit of scary sounding medical speak. Hopefully one of the cards will give us their thoughts but 25-49% sounds like medical management.

Did you know when they did autopsies of 18 yo IS soldiers in Vietnam they found evidence of atherosclerosis. I learned that factoid in med school (or was it residency) and it always stuck with me. You don’t have to have 3 big Macs per day to have blockage. The western diet does this to our arteries.
Last edited by: Old lungs: May 12, 21 13:26
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Re: Racing with LAD Blockage [jflan] [ In reply to ]
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jflan wrote:
what testing did you have in the first place to determine you had a "25-49%" stenosis(CT?), and why was this testing done? I ask because if you weren't having symptoms, this may be a case of ignorance is bliss. "routine" screening isn't for everyone, and when people go looking for things without a necessarily good reason, the outcome can be more harm than good. did insurance request this testing?



I was having issues post COVID and chest pains.


  • Computerized tomography (CT) coronary angiogram (that is where they noted it)
  • Echocardiogram
  • Electrocardiogram
  • Blood test



Note on the food side of things someone mentioned above. I was vegetarian for about 2 years and felt awesome. Moved back to eating meat during the pandemic and have not had the best diet this year. I have been eating better the last two weeks...time to put that plan into overdrive.
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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I am a doctor but not a cardiologist, but do have some interest in this area.
DTOCE on here is the best person to talk to. He is happy to receive PM's (am surprised he has not seen this already).
Firstly, don't stress. Finding some calcifications and blockages is common, but there is a lot of things to consider (and it sounds like your cardiologist did consider them).
You need to see your cardiologist for review, risk factor assessment and modification etc.
Yes the sensible approach is to dial back the intensity etc at the moment until you see them.
But as I said, don't stress, these findings are quite common and that degree of blockage is by no means really bad.
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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I don’t know you, or your diet history, but some of this conversation reminds me of daily conversations I have with my patients. I’ll tell them they have some type of diabetic retinopathy, and need treatment. Many of them will get upset and proclaim “but I don’t understand. My blood sugar and blood pressure have been under great control for the past two years!” I then ask about previous years of control and previously their blood sugar and blood pressure had been very poorly controlled. So, a lot of people think just because they are doing everything right currently (health wise) that their health should be great and without any disturbances. Problem is, your body never truly forgets those years of poor control, and you still have to “pay for those sins”. That’s why someone can be an omnivore for the first 35 years of their life, become a vegan thereafter, and still develop significant heart disease.

Oh, and don’t forget good ole genetics!
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Re: Racing with LAD Blockage [EyeRunMD] [ In reply to ]
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Thank you both (amnesia) for your comments. I am much more at ease today and did my normal meditation to get through.

I think the biggest part that bothers me is that I was performing pretty well in the sport and my performance hit a major snag following COVID that has persisted for over a year now. Genetics, age, etc. all certainly play a factor. It is what it is. I am sure I will be fine. The follow up and second opinion are going to happen.

Again, thanks for the reassurances.
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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LifeTri wrote:
jflan wrote:
what testing did you have in the first place to determine you had a "25-49%" stenosis(CT?), and why was this testing done? I ask because if you weren't having symptoms, this may be a case of ignorance is bliss. "routine" screening isn't for everyone, and when people go looking for things without a necessarily good reason, the outcome can be more harm than good. did insurance request this testing?



I was having issues post COVID and chest pains.


  • Computerized tomography (CT) coronary angiogram (that is where they noted it)
  • Echocardiogram
  • Electrocardiogram
  • Blood test



Note on the food side of things someone mentioned above. I was vegetarian for about 2 years and felt awesome. Moved back to eating meat during the pandemic and have not had the best diet this year. I have been eating better the last two weeks...time to put that plan into overdrive.

Let me get this correct. You had an angiogram and it said that you're 25-49% blocked LAD? First that is a wide spread for an angiogram. Second if you're 49% blocked LAD I'm really surprised by what your MD said.
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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LifeTri wrote:
So I just got hit with a whammy while going through the life insurance process. Apparently I have a "Left Anterior Descending Artery Abnormal 3.3cm Calcified Plaque with 25%-49% stenosis.". Dr. Google tells me this is called the "widow maker". I did see a cardiologist during recovery from COVID last year and I do continue to have issues. I had multiple scans and test run on my by the cardiologist and was told that nothing was wrong with me at all.

Enter USAA

I was quoted at $60/mo for the coverage and they came back and said they would cover me, but for $300 a month because I was a heart attack risk despite all of my other testing coming back perfect. For the insurance company to raise my rate %500, I am starting to think that I should get a second opinion.


That brings me to my question. Is it stupid to train and race with this condition? The cardiologist said I was good to go a year ago and didn't mention a single thing about this blockage.

Your cardiologist said this a year ago before your bout with COVID+chest pains, or after?

Life insurance companies have different interests and rules than health insurance companies.
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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LifeTri wrote:
Thank you both (amnesia) for your comments. I am much more at ease today and did my normal meditation to get through.

I think the biggest part that bothers me is that I was performing pretty well in the sport and my performance hit a major snag following COVID that has persisted for over a year now. Genetics, age, etc. all certainly play a factor. It is what it is. I am sure I will be fine. The follow up and second opinion are going to happen.

Again, thanks for the reassurances.

I feel ya. It is so frustrating to be humming along, feeling like you are at your best athletically (whether that's based on performance or just how you feel) and a health scare come along.

I never hesitate to help a patient get a second opinion, if they want it. In my opinion, I wanna do everything I can to make that patient feel as comfortable and confident as possible. Please keep us all updated, and I wish you the best.
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Re: Racing with LAD Blockage [RChung] [ In reply to ]
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This was after COVID.

COVID was 3/19/2020

CT Ang was 8/7/2020
Last edited by: LifeTri: May 13, 21 6:43
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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I work as a technician in cardiac stress testing. A coronary artery blockage is not operated on until it is further blocked well beyond 50%. I believe 70 or 75% blockage will be intervened on if I remember correct. See a cardiologist and discuss your concerns.

From my experience of a few years in the field there are a few things for athletes to be aware. If your dad/mom/bro/sis had a stent, heart attack, or bypass at a certain age then you better be cautious and prepared for a heart procedure around the similar age regardless of diet and exercise. Genetics is a stronger factor than diet, blood pressure, cholesterol, smoking. The young patients I have seen with heart attacks in their 30's came from a parent who also had a blockage at that age.

Watch out for signs and symptoms. Chest discomfort with exercise and relieved with immediate rest, new shortness of breath with exercise. For a triathlete the first thing you may notice is a drop in performance due to your heart function decreasing with a blockage. Non-athletes usually have more abrupt symptoms because they are not in tune with their exercise capacity, breathing, etc.

Speak with your doctor on a regular basis and know your family heart history.
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Re: Racing with LAD Blockage [piratetri] [ In reply to ]
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Even with 50% blockage your heart will be getting the blood it needs. As mentioned above, it takes about 70+% blockage to start shortchanging the heart under exercise.

Your cardiologist will watch you, and let you know when something needs to be done. And family history will also be a significant driver of his decisions.

Still, it will generate anxiety which doesn’t make things much easier.
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Re: Racing with LAD Blockage [piratetri] [ In reply to ]
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Family has a really strong heart history (good genetics)

All three siblings are in good shape. Both parents are good. Three out of four grandparents had zero issues. The fourth was my maternal grandmother who was overweight, diabetic, and died of a heart attacked in her 70's.
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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I don't have much to say directly about your question. Youre in better hands with amnesia and eyerunmd. Both were a great help to me last year, along with dtoce.

But, for what it's worth... I took 3rd OA in a local 10k 18 months ago, 6 weeks before needing a quintuple bypass with a 98% blocked LAD (along with 6 others all over 90%). It's not a problem, until it is.

We are all different, of course.
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Re: Racing with LAD Blockage [LifeTri] [ In reply to ]
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LifeTri wrote:
So I just got hit with a whammy while going through the life insurance process. Apparently I have a "Left Anterior Descending Artery Abnormal 3.3cm Calcified Plaque with 25%-49% stenosis.". Dr. Google tells me this is called the "widow maker". I did see a cardiologist during recovery from COVID last year and I do continue to have issues. I had multiple scans and test run on my by the cardiologist and was told that nothing was wrong with me at all.

Enter USAA

I was quoted at $60/mo for the coverage and they came back and said they would cover me, but for $300 a month because I was a heart attack risk despite all of my other testing coming back perfect. For the insurance company to raise my rate %500, I am starting to think that I should get a second opinion.


That brings me to my question. Is it stupid to train and race with this condition? The cardiologist said I was good to go a year ago and didn't mention a single thing about this blockage.

I am frustrated and, frankly, a bit scared - wondering if there is anything I can do about this.

I had a LAD blockage (that I didn't know about.) I went for a run and ended up 'dead' on the side of the road. Go read some of my posts on what happened to me in Feb. Listen to everyone... directly to the cardiologist you go.

______________________________________________
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