Cycling post heart attack

sneeble

Hi folks

I'm 39 and recently completed a short 40km cycle race which I did a bit like a time trial...

Unfortunately after bettering my PB by 18 minutes I did my usual cool down and then had a heart attack cycling up a hill back to the car

That was just over three weeks ago. According to the cardiologist, they believe that I had an NSTEMI myocardial infaction caused by a blood clot. I've had an angiogram and they found no sign of any occlusions, faulty heart valves or coronary heart disease.

Basically they believe that it was a heart attack bought on by extreme exertion. I'll agree with that because my heart rate was sitting around the 187-190 range for most of the race.

I would like to hear from others out there that have also suffered from MI's and find out what they did to get back on the bike and any experiences they had/have as a result of being placed on lifelong aspirin and statins. I'm not on beta blockers because my resting HR is somewhere around 42 bpm and I have a low BP - so that's one less thing I need to worry about, but if others are, then please feel free to chat!

- Greg

phil s

I've no experience of this but I just want to wish you all the best in your recovery and also to express how damn scary that story is. Did the docs indicate whether an apparently fit and healthy cyclist might be able to have some routine check to avoid precisely this kind of scenario in the event of a pre-exisiting condition? My teammate is Italian and he is astounded that we don't need to have health checks in this country in order to obtain a race licence.

Mike Willcox

sneeble wrote:

Hi folks

I would like to hear from others out there that have also suffered from MI's and find out what they did to get back on the bike and any experiences they had/have as a result of being placed on lifelong aspirin and statins.
- Greg

Hi Greg

I've had 2 heart attacks. The first one was in April 2004 and occured 2 days after my business collapsed. It happened after playing a squash match for my club. I had felt lousy all day and asked the team captain if I could play at number 4 or 5 instead od my normal position of 2. I had no energy and after a very hard fought match lost 3-2 after an hour or so of playing time. So my HR must have been very highfor a long time.

My angiogram highlighted 2 blocked arteries. The main artery was 90% blocked and the hospital inserted a stent.. The other artery was 40% and in an awkward place so they left it alone. Initially you can hardly walk any distance but over time I managed to get to walk further and further and in the August decided to ride a bike once again (I last rode seriously in 1982).

My goal was to break the hour for 25 miles within 12 months of my MI. I rode a 25 early April 2005 North Middx and Herts and did 1.00.09 on a cold day with Ian Cammish starting one minute behind me. He did a 57 I think so I was well satisfied. Unfortunately I suffered a crash 2 days later when my front tyre blew out on a descent and had a lot of painful injuries.

By the time I tried another come back I was experiencing many ailments and I rode another 25 and could manage something like a 1.9.00 and absolutely exhausted, could hardly stand even. On looking at the internet I found out that all my symptoms related to statin side effects which had destroyed my body's store of CoQ10 and affected my liver and caused muscle wastage. It took me over 18 months to get back to normal.

Do NOT take Statins and do trainimg. It could kill you.

Another come back last year and more crashes winter and early spring, so no sustained length of training and no speed work as such and then in June had an attack of angina for the frist time in my life on a training ride doing some interval training and I thought must get this checked out. Too late at my daughters wedding 3 days later had another heart attack as I sat down after my speech. 2 more stents this time.

Recovery same as before. I have built it up slowly with walks and started riding again in September 07. I don't know how I will fare this time around. My targets are the same.

All I take is 1x75mg aspirin a day and no statins of any sort. I try and avoid stressful situations as this seems to be the root cause of my CV disease but as people on this forum know I can get a bit tectchy at times for which I can only apologise and crave some indulgence.

AcousticDave

I had a heart attack at 25 unexpectedaly and it took me along time to get over it. It wasnt until i started going to the gym and cycling that i put it behind me. That was 15 years ago and so far (touch wood) no further problems.

As Mike said DO NOT take Statins, i was on them for 10 years and suffered someting called Mysiotitis which is muscle breakdown which could lead to kidney failure.

I am on Atenanol 25mg and Aspirin 75mg daily and the doc wants me on Fenofibrates for cholestorol lowering.

sneeble

phil s wrote:

I've no experience of this but I just want to wish you all the best in your recovery and also to express how damn scary that story is. Did the docs indicate whether an apparently fit and healthy cyclist might be able to have some routine check to avoid precisely this kind of scenario in the event of a pre-exisiting condition? My teammate is Italian and he is astounded that we don't need to have health checks in this country in order to obtain a race licence.

Hi Phil,

My GP had previously pulled me up on my cholesterol (a genetic/familial condition) which I had managed to get from 7.6 to 5.2. The general trend was in the right direction, so he was quite happy with my progress. In my particular case, my MI (Miocardial Infarction) was not caused by fatty deposits in the arteries as the angiogram came back as "normal" - which, I think, supports the idea that my cholesterol was going in the right direction. The cardiologists believe that it was caused by a blot clot, their theory being that I had damaged the heart and that the platelets created a clot around the damage, which in turn closed off a small the artery.

So in answer to your question, the Docs normally do a cholesterol test and blood pressure test; neither of which were indicative of any major problems in my particular case - in fact I had been to my GP and been cleared to complete a 160km (100m) back October last year. However, if I was overweight, drank more than 1 glass of wine per day, smoked, ate fatty foods and was stressed to the max then these are all risk factors which I could have done something about.

There are times I hate being a statistical anolomy!

Marko1962

This is very interesting regarding Statins, I know that there are possible side affects of Statins as I have suffered some in the past but it took a few years to cotton on. Approx 3.5-4 yrs ago I was put on Atorvastatin after suffering Renal failure and at first there were no side affects however after a couple of years on them I experienced memory loss on occasion and when I did some cad/cam training I had a great deal of difficulty in remembering much of what I had been taught, I put it down to age (43) and trying to teach and old dog new tricks as they say.

I also was suffering pains and weakness in my forearms and wrists but it wasn't until I read about Statins on tinternet about a year ago that I put 2 and 2 together. After discussing it with my Doc I tried out various other Statins until I settled upon Simvastatin which so far (5 months) hasnt produced any side affects that I know of, however as a cycling newbie with health problems and on Statins it's very interesting what you are both saying regarding Statins and heart problems. My cholesterol was 5.2 after I stopped taking whatever Statin I was on (after experiencing side affects) and starting Simvastatin (a gap of approx 3months) and all of this was before I recently took up cycling and therefore exercising when before I exercised not at all..

So as you can see I have a vested interest in any possible Statin side affect and more so since I am putting some efforts into getting fit and putting in the time and distance through cycling. I think this is something I need to discuss with my Doc in 2 weeks time as I don't want any more health problems on top of what I already have so thanks for the warning guys...

windchill

Sorry- I'm normally a "lurker" rather than a poster but being a doctor I felt I ought to add here. I've no doubt that if you put "statin" and "poison" into google you'll get a lot of horror stories. Equally if you switch "poison" to "saviour" or something you'll get a totally different perspective. Myositis is genuinely life threatening but is fortunately pretty rare (around 1:1000 statin users I read somewhere). Muscle aching/weakness is unfortunately much much commoner and in my experience the commonest reason for stopping.
Definitely discuss it with your own doctor. It may not be as simple as Mike's advice of just avoiding them. For all their problems, they seem to reduce the chance of a second heart attack by about 25%- not great I know but better than nothing. Where I would fully sympathise with him is in relation to a statin's effect on his exercise ability. Unfortunately cyclists ( and athletes of most types) are not well catered for medication-wise. Drug companies will aim at the biggest market areas- which is your overweight, smoking couch potato. He is unlikely to notice the effect on his exercise tolerance with statins/ betablockers etc therefore it's not really an issue for them but a major one for those who it does affect.
Finally- keep the exercise going in some form. I get so depressed at how little I can persuade people to do it. I seriously reckon I would be doing more good if I never prescribed another aspirin/betablocker/nitrate/statin or anything else, and in return could have more success on the exercise front.
Right, I'll probably lapse backing into lurking again.

sneeble

windchill wrote:

Sorry- I'm normally a "lurker" rather than a poster but being a doctor I felt I ought to add here. ....

Hi Windchill. Thanks for your input, it is certainly nice to get some balance here in the discussion. As you say, one of the biggest problems with information presented on the internet is that anyone can post information and not all of it is accurate or relevant.
So, I turned to the BMJ, Lancet and other sources.

"Overall the primary prevention trials in people of average risk with average overweight and cholesterolemia - the ALLHAT and individual statin studies- have not shown that statins reduce all-cause mortality significantly. The only synthetic drug of the past 40 years for chronic prevention of the common major degenerative diseases of adults that has ever been shown in randomized controlled double-blind trial RCT to significantly reduce all-cause mortality by – by 36 to 40% - is metformin: in the epic UKPDS (Lancet 1998)."

"Despite industry hype, there is no data, none, to show that statins are an overall benefit to people without proven coronary artery disease [CAD]. Putting people on a lifetime of medication, when they do not have CAD, exposes them to health risks and major financial costs, for possibly no benefit. Encouraging people to put themselves on a lifetime of medication, in consultation with a pharmacist, does not seem consistent with the goal of promoting public health.

Before we pathologize millions of people as "hypercholesterolemic”, society ought seriously to rethink how we go about the important task of primary prevention of heart disease. Diet and exercise seem likely to be cheaper, safer and more effective."

When it comes to exercise....Use it or lose it. Exercise is an important factor for preventing heart disease. This does not mean training for a century. It simply means light exercise for moderate periods.

Proper exercise keeps the blood flowing smoothly through the arteries by enhancing “endothelial function” and helps to distribute cytokines throughout the body.

The end result is better circulation and prevention of plaque build-up (atherosclerosis). In 2005, the Journal of the American College of Cardiology showed that even a single exercise session improved the health of blood vessels by 25%.

Exercise also lowers homocysteine levels. Homocysteine in the blood is a risk for heart disease due to its ability to scar the arterial wall and therefore elicit plaque build-up.

Finally, exercise lowers blood glucose levels. High blood glucose can increase the risk of heart disease exponentially.

This is why diabetics have a 4.5 times greater chance of suffering from heart disease relative to non-diabetics—high blood glucose.

These benefits of exercise are proof that habits create and eradicate disease, not drugs.