Hi folks

Just had my final sign off meeting with my cardiologist and regrettably, he was non committal on the ability to exercise at a reasonable level.

His opinion (and he admitted doesn’t know much about cycling) is that cycling as I describe it, is an extreme sport.

I described typical road bike run would be 25-30miles, a couple of decent hills. 2hr duration and burn about 2,000 cals.

Typical mountain bike run would be 15-25miles, 2-3hours some big gradients and burning around 2000 calories. This would be typical trail centre red/black.

I also Ski and play badminton at a high level.

All of the British Heart Foundation guides say outdoor cycling is okay, badminton is okay etc.

You might have seen my post previously. I’m 40, had a heart attack on the way home from mountain biking mid December North of Glasgow. Stent inserted etc

13stone, 5’9″, cholesterol 2.1, Bp. 130/85, Ejection fraction 64%.

Cardiologist is saying that I shouldn’t be cycling or skiing at the above level as he cannot say it is safe to do so but at the same time he says he cannot say it is definitely dangerous. He then stated I have a very low risk of having another heart attack but more than a normal person.

Wife is giving me grief, I don’t want to give up my sports as I feel fine and with the exercise I am doing, I am coping with ramping up activity levels.

I’m at the end of my tether, anyone know of a cardiologist that has an interest in sport that I could get in touch with? I did ask but my cardio guy doesn’t know anyone.

Surely that cannot be it for me? The cardiologist did say I can go to the gym 🙁

Any advice would be appreciated.

Thanks

Alan

You’re seriously over-egging the pudding with your 1000kCal/hr – that might have had an influence on them. The badminton, if it’s at as high a level as you say it is, will be far more challenging that pottling about on the bike.

I said on one of your earlier post’s…..stent inserted, job done.
crack on and ride your bike.
I had open heart surgery in august, back riding by mid September.
back at full bore now.
crack on and ride…….we have to die from something….. 😀

I have no answer for you and I’ve never had a heart attack so I can’t really relate.

If I were in your position I would be asking myself how I felt about experiencing another heart attack. Y’know balancing up life without sport vs. family worries etc.

I personally would find it nearly impossible to live without strenuous exercise but then I also understand why my Mrs would be worried about me crocking it.

The 2k calories was from endomondo.

I too would go crazy without exercise. Ton, did the cardiologist give you any advice?

mate, both the cardiologist and the surgeon told me to exercise to how I was feeling. and to stop if I felt bad.
once the surgery is done and has been a success the body needs to get back to normal to heal properly. sitting about doing nothing does not help the body heal.

Explain to your cardiologist that you wish to be reffered to a cardiologist with a sports specific rehab interest, ask him if he knows of any, request all of your hospital notes etc. If your cardiologist doesn’t know of a decent referral, search the www for one and pay privately for their assessment and advice. That way its, transparent, safe & has the biggest chance of getting you back out on the bike at a level you’d enjoy.

Did the cardiologist explain why no cycling – other than “extreme sport”? I’d think about using a heart rate monitor. Set some very conservative zones based on a low 20 minute threshold garnered from badminton, then exercise to Level 2-3 (endurance to tempo) based on your threshold. I would have thought that continuous low intensity endurance will be better for you than extremes. So you will be spinning up some hills for a while. IANAD

BTW, I don’t manage 1000 kcal/hr road racing. About 900 is the highest I seem to achieve (based on a real power measurement). Bimbling, it’s 30 kCal/mile. More for hilly stuff.

The Cal/hr from endomondo is maybe a bit optimistic. I have a Suunto Quest HR monitor and I am using it for all activities. I cannot get my heart rate above 110 at the hospital rehab classes but when playing badminton for say 1.5 hrs, my average HR is around 100 and peaked at 138. I cannot seem to sweat at the recommended cardio zones and only break into sweat above 130bpm.

I did try a Sufferfest session on my turbo, Elements of Style video and according to the HR monitor, I was working consistently at 140bpm and peaked on heavy climb at 170. Sweated profusely and was insanely hungry the next day. Clearly, it kick started my metabolism. First time I felt that I had exercised it felt great.

I haven’t wanted to go into a new regime without checking with the Cardiologist as I was told that I shouldn’t embark on anything until at least 8 weeks. I have emailed Sports Cardiology UK to see if they will see me.

Really frustrating

Take 140 as a threshold, define zones based on this and exercise accordingly. I’d hope your threshold should increase as you heal.

From the British Cycling HR/Power calculator

FTHR: 140
Heart rate (Beats per minute)
HR Zone Low end zone High end zone
1 .. Active Recovery < 95
2 .. Endurance 95 to 116
3 .. Tempo 116 to 131
4 .. Threshold 131 to 147
5 .. VO2 max 147 to 169
6 .. Anaerobic capacity N/A N/A

You’ve already been over threshold, but building endurance will be more important than peak. Badminton looks like endurance.

EDIT: Seems to agree with some of the publications on Cardiac Rehabilitation programs that set targets based on resting HR plus some factor (50-70%) or a fraction of tested maximum. Forget that 220-age theoretical maximum, and the observed 170 max (guidelines require a controlled test – sufferfest may not qualify 😉 ).

Exercise heart rate guidelines overestimate recommended intensity for chronic heart failure patients

Fist of all sympathies and lad that you are home and well

Sadly I have no useful advice but I think that i would certainly be looking to pay some one to look over my file ad give a more informed opinion

Now I’ll risk as an amatuer opinion

I thought you either are at risk over loading he heart and then you’d be on beta blockers so you can’t over load it

Or your not on medication and your heart is good to go

Are you on medication?

Another amateur opinion. I think non committal is much better than being told not to

ride but listen to your body.

A ride does not need to be full gas to be fun. Enjoy the views, take the wife, stop at the pub, ride somewhere new. Before long you will be enjoying your riding again and not worrying about your heart.

I don’t tend to hit it too hard, it was just the blanket approach that was bothering me. I’ll be monitoring HR to make sure not over doing it. I am on bisopropl 2.5mg. Apparently, physio just deducts a factor of 30 just because I’m on that drug. And this recommended level will be for life?????

I don’t know whether you were born with a heart condition or not, but there is a patients association that does webinars. Some of these are about exercising with a heart condition and may be of some interest:

Sports Cardiology UK looks like a sensible option, good luck