Right, I have had 3 heart attacks (2019-2020) and have a damaged heart & a chest full of stents. After each it seemed that they couldn't wait to discharge me so I have no cardiologist & my GP surgery don't seem particularly interested in talking about it beyond "keep taking the pills and carry on". At some point along the way I was told that I should be able to do pretty much everything I had done before.
I've been cycling regularly since (although only around 50 miles a week) and pushing myself reasonably hard on climbs; I've felt much better as a result.
However, at times I've started feeling pretty exhausted afterwards, especially if I've done my rides on consecutive days. I'm not sure if this is heart related but have a nagging feeling that it might be (heart attack survivors are prone to over focussing on the chest area). I'm not getting any chest pain. My GP doesn't seem at all concerned.
BHF seems to suggest that exercise shouldn't take you beyond the point of being able to talk. When I'm winding my heavy bike up a steep hill I'm breathing pretty hard and would probably struggle to hold a conversation.
I might be being overly sensitive and it might simply be that I need to avoid riding on consecutive days, perhaps I need more recovery time as I age (58) but I want to maximise my life expectancy not shorten it. Any thoughts?
Just to be clear, I have no chest pain/tightness, haven't used my GTN spray in 5 years and there's no shortness of breath under normal circumstances or fluid retention. I am on buckets full of medication with a whole host of potential side effects. My beta blockers seem to limit my heart rate to 150-155 bpm tops (very occasionally I might just tip over this).
I am expecting [hoping] to feel much more energises now that Spring & Summer are looming, the long, wet winter has been a bit of a slog.
I've a riding buddy who has had a significant heart attack and has 4 stents as a result. I'm continuously worried about him pushing too hard when we are out (he is very much of the no pain, no gain school), and it got me thinking. Would this not be the perfect application for an ebike linked to a heart rate sensor? The idea being that the ebike assistance would ramp up to keep you in the 140ish heart rate zone rather than bumping up against the beta blocker limit.
Not saying this is the solution for you but it might be something to consider even though the sensor link thing doesn't exist as yet.
I think this book is mostly about arrhythmias but might be worth investigating if it has chapters on heart attacks
If link or borked it's the haywire heart by lennard zinn
In our small group we have three people with heart problems including one who has had a triple bypass. They all manage very well but don’t push it too hard. They are all still better riders than me
Beta blockers themselves could be enough to prevent you from ‘backing up.’ I was on them in my late teens into 20s and playing first team football at uni. I’d be shattered at the end of a game and cramping and could never play again the next day.
Scratch that. Amflow have just released a smart heart link that does exactly what I was suggesting above. At last!
2 things that jump to mind, the first is that you should have had a cardiac rehab course which covers things like this. If not then it's probably not too late to get referred onto it by your GP.
The second, is that as other's have said, beta blockers are probably slowing your recovery.
There is a sweet spot to pushing yourself, go too far and even if you don't have heart problems, you're probably doing more harm than good - see ultra-endurance athletes...
I think I ended up doing 4 cardiac Rehab. courses although I don't recall being told to completely avoid high intensity bursts. I seem to recall aiming for around 130bpm, or there abouts, for the duration.
With my cycling I'm far from flat out the whole time, but there are usually some harder pushes on climbs that leave me feeling a bit knackered.
As people have said, it could be the beta blockers. I've been on them since the first heart attack so don't really know what might be caused by the heart damage or by the tablets themselves (I gather from folk who where far better athletes than I was prior to starting on them, that they can really impair performance/recovery).
I shall try avoid cycling on concurrent days (I usually only go out a couple of times a week so should be able to avoid this happening too much).
If you feel it’s impacting your life then don’t be shy to discuss with your GP. It maybe that there’s a better alternative to beta blockers that can help without impacting your endurance and recovery.
Mahle ebikes have an option to have assist react to heart rate.
Fatigue after consecutive days riding might simply be you are trying to increase ride volume too quickly, in recent weeks I've done a couple of 1.5-2.5 hour ebike rides after a winter of typically sub 45min turbo trainer rides and having some sort of lurgy mid Feb to mid March, both have left me feeling quite battered for at least a couple of days.
It’s no secret I find it harder - hence why I now ride an ebike. I have non-congestive heart failure - so pain wasn’t an issue. Unfortunately I am on beta blockers and that negatively impacts my hear rate. My recovery time is hugely improved and it lets me ride with a group and not hold anyone up.
I had a heart attack when I was 58, I had five stents and after a recovery period and a ten week rehab course (half a day a week) eventually got back on my bike. I take beta blockers as part of my drug cocktail. I ride now and see how I feel mostly I can do rides on concecutive days if I want to but often will do some other form of execise like walking or kayaking in between.
I can't ride as hard as I used to and 50mile mtb rides are a thing of the past now. I do 30 to 50 mile gravel or road rides with very few proper mtb days. I just go as hard as my body lets me and don't try to compete with people.
I am 72 now and this week have done a 27mile gravel ride, a 45 mile road ride and a 41mile road ride on the consecutive days.
I am much slower on hills than I used to be but talking to some of my cycling peers (78 and 80 years old) this seems to be also part of ageing.
I could probably go faster and train more but I am never going to win a race now 🙂
To be honest, I am happy to be able to do the things I enjoy even if I have to dial it back notch.
That's encouraging Bruce, thank you.
You've got a few years on me and it sounds as if you do a fair bit more.
I shall keep going 👍
I wouldn't discount the fact that you're only riding about 50 miles a week - what did you do before? Add in your age and it might simply be that you're dropping fitness slowly, and thus more tired than you're used to
Yes, I'm your age, or actually a little over
Why not track down a sports cardiologist? You'd probably have to pay, but it might answer your questions. Then you'd be in a better position to set expectations and put a training plan together. I've had joint/ tendon problems which I wasn't getting very far with, and a separate opinion was really helpful.
Not heart, lungs for me. I had a Pulmonary Embolism a couple of years ago and ended up in Intensive Care for a week or so. On exit, I couldn't string a sentence of more than 3 words together or walk more than about 25m. I'm definitely old school no pain/no gain plus a bit of **** it, what could possibly go wrong...
I kept my HR below 150 on anything I did during recovery. Started walking first. Initially metres then part miles then more miles then jogging then running then riding. I did King Alfreds Way again a couple of months after the issue, keeping HR below 150. It was probably a mistake but obv didn't kill me so all good, hey...
At 50 road miles per week, you're probably losing fitness. At lower intensity it's not enough (IME). You don't need to do consecutive days. Do maybe 3 rides per week at say 100 miles total, max HR at whatever suits your fitness - for me, it'd be 150 or less.
I built my fitness back tho I'm not where I was. Leading up to the PE, I did a year of 10k miles riding with 52 mile centuries and 2k miles running with 26 half Marathons. I'm nowhere near that now but ride maybe 200 miles per week and run maybe 40 miles with the occasional century or half just to pretend I'm still fit.
The message is, use your HR as a max rev counter/limiter and manage your activities within each 7 day window to level the load. Obv I'm not a medical Dr so all this could be total bolleaux... And bon chance 👍
Why not track down a sports cardiologist? You'd probably have to pay, but it might answer your questions
that’s where my thoughts were. The NHS can unfortunately only do the basics these days
However is any doc going to tell you much more ? ie would they just say you have heart failure, your risks are x, y , z
I know a mate of mine who had a stroke and heart attack was told not to exercise over x bpm for 12 months and then ‘be sensible after’
I have some heart issues and on lifetime meds now. The cardiologist, a keen roadie, recommended I set HR alarms on my Garmin, use a good chest HR strap and keep it below threshold as much as possible. His advice was do as much sweet spot riding as possible and it should reduce likelihood of any future cardiac events.
Don't have any heart issues as far as I'm aware, but Ive found doing lots (3 hrs) of Z2 on the turbo has really helped with base fitness and I can get up hills at much lower intensities. Worth finding out if something like that would be beneficial for your ticker.
16 years with heart issues. various treatments failed. open heart surgery worked for 8 years, now reverted back.
all you have to do is move your goalposts.
dont ride hard, ride steadier but further/longer. i aim for between 100 to 140 miles a week.
still something to aim for. i use a garmin venu watch. keep a eye on my HR. get up to 190bpm on steep hard climbs. but dont stay there for long. my recovery is pretty good too now i ride with a bit of a plan.
I'd say it might be worth paying private for an hour or 2 with a cardiac specialist. Orthopaedic consultants cost £250 ish for an hour so I'm guessing a cardiac specialist would be similar. If you can afford it, I think it'd be money well spent on getting some expertise.
Thanks for all the replies.
I'm a keen but not very hardcore cyclist, I ride for a mixture of fun and the benefit it has on my mental & physical health. I'm not in training or chasing times nor am I trying to squeeze out every last bit of performance. I also tend to get set in my ways and ride the same couple of loops weekly (with some other excursions when the weather's good).
My heart trouble came as quite a shock (I was given a less than 5% chance of heart issues due to the results of a lifestyle assessment at the surgery a day or two before the first & biggest heart attack - whilst out cycling as it happens) so I'm trying to keep it in good nick if I can and my weight in a decent range.
I do push myself hard regularly on climbs though, pretty much to the point where I think the beta blockers are the limiting factor and it seems that advice on the BHF website suggests that you shouldn't go all out (to the point of not being able to hold a conversation - a somewhat vague level in my view) and I'm wondering whether this is unwise.
I can set heart rate warnings on my Edge Explore 2 although I guess that a lot depends on how accurate the zones are. I realise that the serious cycling folk aren't keen on the 220-age approach (and this may be true if you're performance/optimization focused) but it seems a reasonable rule of thumb (I'm pretty sure that the cardiac nurses in the rehab groups used this or something similar). This gives 162 for me but in reality 150-155bpm seems to be my limit (this hasn't changed much in 4 or so years), although very occasionally I seem to get the same climbs/levels of excursion giving me 5-10bpm higher reading, but I'm not sure if this is my heart or my somewhat erratic Garmin HRM (according to Garmin beta blockers may affect HRM accuracy).