On the SFB ‘man down’ thread I posed this question:

Can any medics comment on the nature of a heart attack in someone who is a regular cyclist and therefore likely to be pretty fit? I think it would be a useful discussion here and help raise awareness of potential heart conditions that fitness won’t prevent but could help reduce the impact of.

And quite a few people have suggested we start a new thread so here it is. I know that the risk of heart attack can be related to many factors other than just life style, but I don’t know any more than that and there is loads more I don’t know that other people clearly did.

Some light reading for you.

http://www.bhf.org.uk/heart-health/conditions/cardiovascular-disease.aspx

as some of you will know, i have got a existing heart problem, i am currently waiting for a op that will hopefully fix me.

when my problem started, the cardiologist and heart dr asked me about my sporting background, i told him that i had been a life long cyclist, also that i had done a few triathlons over the years and also played rugby for 25 yrs.
i was quite shocked when they told me that people who had done a lot of endurance sport were one of the main groups that suffered from AF.
i thought my problems had occurred cos i was overweight at the time, they both told me otherwise.
the cardiologist told me that in laymans terms, my pipes were clear.

i don’t know what is right or wrong, but when a heart man at one of the countries leading heart centers tell me this, i believed him.

and Simon has ridden more than most of us, so maybe the endurance/heart problem thing may have some truth.

Obviously there are loads of different heart diseases, with different causes and different symptoms.
Most people would recognise a cardiac arrest (heart actually stopping) and a “classic” heart attack (vice-like pain in chest, etc).

However, not many of us know about “silent” heart attacks, which can be relatively symptomless. In fact, some people only discover they’ve had a heart attack much later, for example with a pre-op ECG.

Silent heart attacks aren’t some mild girly low-fat version, and can be just as damaging as the classic sort. I only know about them because my first Bike Buddy had one. But last April, on a gentle off-road ride, another friend C mentioned she felt “a bit weird”, and had pins and needles in her left hand. Thank goodness we recognised what might be happening, and took her to hospital immediately.

In C’s case the heart attacks were triggered by inflammation of the heart tissues, not by a clot or blocked arteries.

So, don’t be nervous of over-reacting – better safe than sorry 🙁

Drac’s link above is a good one.

The five major “risk factors” for having a heart attack (caused by the blood supply to the heart being interrupted by serious narrowing/furring up of the arteries) are:
– smoking
– diabetes
– high cholesterol
– high blood pressure
– family history

There are others, but these are the main ones and the only ones I tend to ask about when a patient is admitted with chest pain. You can’t do anything about the last one, but the first 4 are all controllable.

If you are interested in seeing your risk of having a heart attack in the next 10 years, put your information into http://qrisk.org/ . It’s a risk calculator developed at Nottingham University and is a great resource.

Finally, cardiac arrests can be a bit more unpredictable. They are most often caused by heart attacks, but can be caused by weird and wonderful things eg in Fabrice Muamba’s case. Everyone should know how to do basic CPR IMO, as it’s the quality of CPR and how quickly it is started that makes the difference to a patient’s outcome after a cardiac arrest.

Familiarise yourself with Vinnie’s video:
[video]http://www.youtube.com/watch?v=ILxjxfB4zNk&feature=youtu.be[/video]

PS. I’m a cardiologist, not just a very enthusiastic random

Heart attack symptoms also differ between women and men. Females may have very ‘mild’ symptoms

Interesting the possible link between long term sport activity and AF. I’ve looked at a couple of articles, one thing they’re not entirely clear about is what sort of activity levels they’re talking about. I’m interested because this quote from a medscape article ( link) sums me up quite well (apart from the flutter bit!):

The typical clinical profile of sport-related AF or atrial flutter is a middle-aged man (in his forties or fifties) who has been involved in regular endurance sport practice since his youth (soccer, cycling, jogging, and swimming), and is still active. This physical activity is his favourite leisure time activity and he is psychologically very dependent on it.

Of Legolam’s hitlist I was fine on the first 4, mixture of family history and stress that got me. I hit the deck four days before I was due at the Great North Run, really lucky because I would have had a problem getting out of all those people.

Retrospectively I always had problems getting going at the start of a ride, especially uphill. No pain, just out of breath and legs going to jelly.

Since realised (through rehab sessions) that this was probably down to the arteries to my heart not being properly dilated and therefore not getting enough oxygenated blood to the heart.
As I was “fairly fit” I ignored this and just thought I had to get fitter.
Simultaneously I was struggling to achieve more than a 10 mile run, again put this down to fitness and age. No pain just out of breath and stamina.

I now have a proper warm up before relatively hard exercise and use a HRM to make sure I don’t push things too hard.

I know people whose symptoms were picked up in time, have had angioplasty and stents and are in good shape again. If you think you have an issue please get checked out before you hit the deck, otherwise the recovery is far longer and you may not get back to the same level of fitness, I know I never will.

While we’re doing this, can someone explain why SFB would be also dealing with kidney infection and lung problems as a result of his attack at the moment?

Lung problems could be down to a damaged lung from the CPR or possibly due to aspirating on vomit when CPR was given due to it going back into his airway. Kidney infection I’m not sure but he would have had a catheter fitted when he was in ITU and there’s always possibilities of infection when someone’s catheterised.

I believe that cardiac patients often get a fluid build up in the lungs after surgery.

Stoner there could be many reasons for lung problems. Its probably not best to speculate on an forum.

Just google heart failure though, and that will give you stuff to read.

I think it’s less likely to be a ‘kidney infection’, and more likely to be an acute kidney problem caused by a period of low blood pressure which in turn may be related to the original event or to a subsequent infection elsewhere, like in his chest.

Your heart acts like a pump. When it doesn’t work very well, your various organs don’t get perfused very well, limiting the amount of oxygen they receive and the amount of blood flowing through them.

Kidneys are very dependent on blood flow for their function, and do shut down for a while if their blood supply is sub-optimal.

It gets called Acute Kidney failure, or Acute Kidney injury, but is usually a temporary condition.

Cheers crikey, v interesting.

May I just add- being on the sauce/hangover the next day aint good for you. So dont ride off a hangover IMO.

Afterall would you hit the gym hard with a hangover?

The lung infection is most likely secondary to being on a ventilator. When ventilated most of your normal barriers to lung infection are bypassed and its incredibly common you get pneumonia. Its called vap – ventilator acquired pneumonia. Wishing simon all speed in his recovery