What could be more full monty than an multiple bypass? Maybe a valve replacement.
I friend of mine (not endurance athlete) just had mitral and tricuspid valve repaired which was quite a big deal. He is same age as me 58 and doesn’t have any negative habits. He is an emerg doc and attributes it to the tremendous strain of divorce from his wife who seems quite psychotic.
I wish him a speedy recovery as well. Being a lifelong athlete, he will have a better chance of a quicker recovery for sure.
BUT, let’s make sure everyone understands that CAD risk does not increase with endurance training or HIT training or any of that. CAD risk happens with age, genetics and all the added risk factors (HTN, DM, hyperlipidemia, as well as the less likely for triathletes-smoking and inactivity). It’s why I preach that everyone should get coronary artery calcium testing done as a routine screening test at some point if you are over 50. Perhaps earlier if there is earlier family history or other added risk.
All endurance athletes have increased risk for afib, but that is not what we are talking about regarding his cardiac surgery. And aortic aneurysms are altogether different as well.
**I believe that he would have needed this earlier in his life if he wasn’t an athlete taking better care of himself than most.
Good thing he always rinsed his cottage cheese to keep the fat down… ;-). Hope all goes well Dave.
I wish him a speedy recovery as well. Being a lifelong athlete, he will have a better chance of a quicker recovery for sure.
BUT, let’s make sure everyone understands that CAD risk does not increase with endurance training or HIT training or any of that. CAD risk happens with age, genetics and all the added risk factors (HTN, DM, hyperlipidemia, as well as the less likely for triathletes-smoking and inactivity). It’s why I preach that everyone should get coronary artery calcium testing done as a routine screening test at some point if you are over 50. Perhaps earlier if there is earlier family history or other added risk.
All endurance athletes have increased risk for afib, but that is not what we are talking about regarding his cardiac surgery. And aortic aneurysms are altogether different as well.
I believe that he would have needed this earlier in his life if he wasn’t an athlete taking better care of himself than most.
Thanks for the clarification.
Back to training 20 hrs per week now (pink optional). But all kidding aside, it life all about the years we live or the lives inside those years. If Dave Scott drops dead tomorrow (I don’t wish that on him), the guy has lived a life beyond the wildest fantasy lives of most humans and this rodeo on this planet does not go on forever, so let’s use these bodies we have to enjoy the years we live, not live less to prolong the years in fear of having less years. None of us knows how many years we get. There is a bolt of lightening, a car crash, that can end it all in the next hour or next day. So in the scheme of quality of life vs risk tradeoffs, even if endurance sport has risk, largely they are worthwhile risks to take.
If Dave took risks on his health to win 7x in Kona and he dies at 70, those seem like worthwhile risks. I hope he lives longer for sure.
What could be more full monty than an multiple bypass? Maybe a valve replacement. //
From the Ninjago cartoon, the ultimate, ultimate…Heart Transplant…And now that one can get a custom pigs heart as a stop gap to a human one, imagine it will be as commonplace as pacemakers were 50 years ago…
I wish him a speedy recovery as well. Being a lifelong athlete, he will have a better chance of a quicker recovery for sure.
BUT, let’s make sure everyone understands that CAD risk does not increase with endurance training or HIT training or any of that. CAD risk happens with age, genetics and all the added risk factors (HTN, DM, hyperlipidemia, as well as the less likely for triathletes-smoking and inactivity). It’s why I preach that everyone should get coronary artery calcium testing done as a routine screening test at some point if you are over 50. Perhaps earlier if there is earlier family history or other added risk.
All endurance athletes have increased risk for afib, but that is not what we are talking about regarding his cardiac surgery. And aortic aneurysms are altogether different as well.
I believe that he would have needed this earlier in his life if he wasn’t an athlete taking better care of himself than most.
Thanks for the clarification.
Back to training 20 hrs per week now (pink optional). But all kidding aside, it life all about the years we live or the lives inside those years. If Dave Scott drops dead tomorrow (I don’t wish that on him), the guy has lived a life beyond the wildest fantasy lives of most humans and this rodeo on this planet does not go on forever, so let’s use these bodies we have to enjoy the years we live, not live less to prolong the years in fear of having less years. None of us knows how many years we get. There is a bolt of lightening, a car crash, that can end it all in the next hour or next day. So in the scheme of quality of life vs risk tradeoffs, even if endurance sport has risk, largely they are worthwhile risks to take.
If Dave took risks on his health to win 7x in Kona and he dies at 70, those seem like worthwhile risks. I hope he lives longer for sure.
“You get what anybody gets - you get a lifetime.†- Neil Gaiman
I just started a new thread for this, guy certainly deserves it. SO tow of the big 4 are going in to get cracked open next week, thank you modern medicine:
https://forum.slowtwitch.com/forum/Slowtwitch_Forums_C1/Triathlon_Forum_F1/And_now_Scott_Tinley_joins_our_elite_club_too…_P8134356/?forum_view=forum_view_collapsed&;page=unread#unread
Back to training 20 hrs per week now (pink optional). But all kidding aside, it life all about the years we live or the lives inside those years. If Dave Scott drops dead tomorrow (I don’t wish that on him), the guy has lived a life beyond the wildest fantasy lives of most humans and this rodeo on this planet does not go on forever, so let’s use these bodies we have to enjoy the years we live, not live less to prolong the years in fear of having less years. None of us knows how many years we get.
Dev - I agree 100%. Hell, I think Dave could have keeled over at age 50 and would still have “lived a life beyond the wildest fantasy”. I would say the same about Phelps as he could have died at 32 and would have had the “wildest fantasy life.” I think this is true of most top athletes. As a less exalted example, I know a guy who played McEnroe in the first round at Wimbledon on Center Court. He was leading by 5-2 in the first set before Mac came storming back and beat him in straight sets. That was the highlight of his limited pro career but still, most tennis players would give their left ball get to play Mac or anyone on Center Court. 
According to Scott´s IG, today (Monday 3rd of June) is the planned surgery! Prayers for Dave to get through this well.
Sound like all went well.
Great news!
Hoping Dave has a fast and full recovery. It is a tough one and accepting limits may be difficult.
i don’t know that i would’ve chosen “dave emerged on the other side” as the phrase describing his surgical outcome. aside from that i’m very glad he’s made it through his surgery successfully. interesting to me that both dave and scott tinley need open heart valve fixes. i had not identified valves as part of the old athlete heart paradigm. i wonder if, in addition to arrhythmias, this is an old endurance athlete thing.
when i heard that both these guys were going in for open heart surgery i was reminded of jefferson and adams, lifelong great friends and occasional great adversaries. just before john adams died he said, “thomas jefferson survives” not knowing that jefferson had died hours before. of course i hope both these men live another 20 or 30 years. so it is with my generation of triathletes.
i feel like somebody who’s been really lucky to have come up in triathlon when i did. with these guys. tinley and i (and monty here, and skid, a bunch of us) did our first IM in kona’s first year, in 1981. I’m tinley’s same age. when the world was settled and pacified and there was nothing left to discover we in our own way found something to pioneer through our early participation in triathlon.
That was curious to me as well. Of course I have heightened awareness, particularly to valve issues (and aortic stem issues) after Riley went through open heart surgery. I too have not seen or come across correlations between endurance and value issues.
Wishing Dave the best!
I too have not seen or come across correlations between endurance and value issues.
it is not an older endurance athlete thing
there is no association between valve issues or aortic aneurysm with endurance training as a primary cause beyond the expected minimal TR that happens with dilation of the heart from endurance training which leads to increased blood volume
the aorta does not and should not dilate and the other valves do not have issues with endurance training
the aorta does not and should not dilate
on this thing. in my imagination i could imagine an athlete like dave scott bored and ported, like a late 60s big block. that it either dilates through training or, if that’s not a thing, that it just starts 4.5cm or 5cm and that’s part of why certain athletes are just good.
that would be pretty easy to test. of course i take your word as gospel on this. but has this been tested? as in, have really good athletes, from say middle distance runners up, or cyclists or swimmers, had their aortas measured? either as an absolute measure or a width as a function of height?
the aorta does not and should not dilate
on this thing. in my imagination i could imagine an athlete like dave scott bored and ported, like a late 60s big block. that it either dilates through training or, if that’s not a thing, that it just starts 4.5cm or 5cm …
People are not born with dilated aortas, but it can occur with time or if there are genetic pre-dispositions to it-like Marfan’s syndrome or other connective dissue diseases…bicuspid aortic valves are associated with dilated aortas and I have lots of patients with that and who have thoracic aneurysms that are being followed…
I remember talking to Dr. Baggish about this as well and he did do a study in 2020 and suggested that endurance athletes may have a very slight predisposition to dilating their aorta over time, but it was minimal and only rarely happened to extent of even moderate dilation. This study looked at elite rowers and Boston Marathon runners.
Long-term Endurance Athletes Are at Marked Risk of Aortic Dilatation - Mass General Advances in Motion
Association of Ascending Aortic Dilatation and Long-term Endurance Exercise Among Older Masters-Level Athletes | Cardiology | JAMA Cardiology | JAMA Network
hoi200003f2.png (1904×2466) (jamanetwork.com)
If you look at the table, the aortic measurements were mostly just outside of normal, only very mild dilation–not requiring surgery kind of dilated.
Aneurysms start ~4.0 cm and need surgery at 5.5 cm
By the way, never take anyone’s word as gospel–question everything to the point of understanding…
Aneurysms start ~4.0 cm and need surgery at 5.5 cm//
As you and I have talked about in the past, this is good news for a lot of us. But I do wonder about the affect that a life of endurance sports has on this, and if a larger than normal opening is somehow a + in the physiological column that athletes excel in. Mine is certainly getting larger over the past 5 years, but I really dont know where it started before I began my calcium scoring. And it appears that guys around my age who are lifelong athletes, are 20%to 25% more likely to be at or above that 4.0 number???
SO do we know yet how Tinley did with his surgery, think they were the same day??
What was your calcium score? I’m 47 and mine was 15. I’m very overweight but have a pretty food diet and am moderate active.
I’ve hesitated to jump in on this discussion since I’m still pretty traumatized but… Eight months ago (Oct 2023) I lost my 67 year old husband to an ascending aortic dissection that happened while we were riding bikes in Mammoth Lakes, CA. Actually, we were riding road e-bikes because I’d lost a kidney 10 months prior and we decided it was time to back off. He was a long time Masters cyclist who focused on time trials and was at one point 3rd at Masters Nationals in the competitive 50+ age group. Was it the 40+ years of high level endurance training? I don’t know. He’d had a stress echo three months prior (July 2023), where it was discovered he had a bicuspid aorta valve and a very slight dilation of 4.08. Apparently the dissection was not aneurysmal in nature. There were no warning signs - we set out on what was going to be a 30 mile ride that he decided halfway through he wanted to extend to 40. He was a little whiny about pain so I’m sure he would have said something if there’d been any chest/back pain leading up to this.
Is there a lesson for endurance athletes in this? I don’t know. I don’t know what we could have done differently, other than not being in Mammoth when it happened. My understanding is that 60% of dissections fall below the 5.5 surgery criteria. I trust his cardiologist (Monty, if you’re reading, it was the cardiologist at LA Cardiology whom Dr. Cannom referred me to when he retired), who was shocked and went back to review the stress echo but didn’t see anything he or we could have done differently; I really don’t think he was saying that just to cover his ass. What I can say is that I wouldn’t wish the pain my husband went through then and the pain I’m going through now on my worst enemy - we were together for 35 years and very happily married for almost 32. I didn’t see this coming. I would just encourage people to be cautious and proactive. It may not have changed anything for us, but maybe it will for someone else.
(sorry, way too long already, I know) I was looking at some of the work of Dr. Lars Svennson at Cleveland Clinic and did see this, but don’t really know what to make of it. It looks like just incidental/anecdotal findings at this point. From this podcast in 2021:
Lars Svensson, MD, PhD:
“I have seen it with golf, rare, but it can happen if it’s enlarged aorta. Swinging a baseball bat, chopping wood with an ax. Now, that’s not a sport necessarily, but it’s exercise. Interesting in the literature, there’s actually quite a lot of patients who have dissected with cycling. I don’t have a good explanation for that. Swimming, particularly crawl or freestyle, as it’s called, seems to occasionally and I’ve seen patients dissect with that. Basketball is another group of patients that we’ve obviously also even seen that related to players on the field. Rowing machines seem to have some risk. That has been documented also. And so those are some of these sports that we know of, that there is some risk of aortic dissection.”
when the world was settled and pacified and there was nothing left to discover we in our own way found something to pioneer through our early participation in triathlon.
💪â¤ï¸
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