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Discussion Starter · #1 ·
Hi all,

Only 38 but I was just diagnosed with a mild ischemia--blocked artery-- going on many drugs and no angiogram for now.

Anyone else here in my situation?

How about max heart rate?

My cardio is overly cautious and anal and feels that going over 120 BPM is a risk.

I've seen other places that reccomend different rates etc.

Anyone else here in my situation??
 

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Discussion Starter · #2 · (Edited)
Thanks for the reply!!!!

Mild inferior ischemia diagnosed with a nuclear perfusion (thallium stress test)
No definite symptoms, strong family history, high cholesterol, blood pressure is normal- high.

I'm basically fit, but about 40 lbs overweight... do exercise a lot but still eat too much!! Just lost 7 lbs and trying hard though.
 

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"My cardio is overly cautious and anal and feels that going over 120 BPM is a risk."
.
"I'm basically fit, but about 40 lbs overweight"
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What does he know?.....You can only die once..... Just take your HR. up to 180 a few times, and get back to us....(if you can)
 

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Discussion Starter · #4 ·
MR_GRUMPY said:
"My cardio is overly cautious and anal and feels that going over 120 BPM is a risk."
.
"I'm basically fit, but about 40 lbs overweight"
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What does he know?.....You can only die once..... Just take your HR. up to 180 a few times, and get back to us....(if you can)
Thank you for the comments -- asshat....

I'm in pretty good shape...in fact I can outride my skinny friends and keep up with wife who is a triathlete.

People can be physically fit and still carry extra pounds.

The opinion of ONE cardiologist is just that.....the opinion of ONE cardiologist.

I'm looking for opinions and other experiences and will also do my own medical research with the help of my wife whom is an MD.

If you don't have anything productive to add.....pls pound sand.
 

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cynical hostility?

Wow! 38yo?
I would continue to learn about health risks- it is most likely that your physician cannot point to clear evidence for keeping your heart rate below 120bpm.

the doc may be worried about a blot clot breaking loose during exertion, and causing an acute ischemic attack - including a stroke. But there are many people with coronary artery occlusion who exercise to a HR beyond 120bpm regularly. At 38yo, working at 70% of max heart rate would be about 127 bpm.

If that is the case, I would further research how to avoid the risk of stroke. They may want to clear your arteries surgically, like baloon angio.

the weight itself may not be the problem - we don't know your height/weight, so it is difficult to tell how bad "40 lbs overweight" is. If you are avg height 5ft 10in, and are 40 lb above the top of "normal" bmi, that would be 40 lb on top of 170 lb, = 210 lb. That is barely into the "obese" bmi range. so you have barely crossed into the range where weight itself would confer morbidity and mortality risk, and at the age of 40, that risk would not typically be playing itself out - heart attack incidence is very low for those under 45yo.

And exercise is very protective. But we don't know the time span that you have been cycling. I would guess at least a few yrs from your RBR membership time.

So you might be in the small group of people with a strong hereditary component to heart disease. And/or you might have more "cynical hostility" than the average person. Your response to the attempt at humor would go along with this possibility.

Look up "cynical hostility" on the web, and see if it sounds like you: suspicious of others' motives, believe everyone is out for themselves, and this mindset gets you angered often. The problem with this worldview is that when your blood pressure goes up in response to things you experience during the day (many things will make a cynically hostile person get irritated), it stays on your mind a long time and provokes your cardiac system to stay in the agitated, elevated state into the night.

The theory at this point is that this may cause damage to the cardiac arteries, leading to higher blood pressure as well as arterial damage - arteries develop "scar" tissue that clogs the artery.

If that is part of the whole problem, you can get a book on recognizing and modifying this personality style, or work on it with counseling.

They used to say "type a" people were more prone to heart disease, but they have figured out it is the cynical hostility part of the type a profile, not the other components such as always feeling time-pressure and being driven to succeed. So the good news is you would really just have to target the cynical hostility if this is the case.

Please don't jump on my case for making any of these suggestions or sharing any of this evidence or theory. Good luck.
 

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Speaking from experience, 40 pounds is a LOT

Gazoo said:
I'm basically fit, but about 40 lbs overweight... do exercise a lot but still eat too much!! Just lost 7 lbs and trying hard though.
Don't minimize the effect of that 40 pounds. I have a different heart issue (atrial fibrillation), and I was complacent, even proud of myself for gaining "only" 2 or 3 pounds a year--until I realized I'd been doing it since the Reagan administration. I'm 6'4", and I was pushing 260, at least 50 pounds above my ideal weight. But I was still telling myself I was basically OK, just could stand to take off a few pounds.
Two summers ago after my father died, I really started working at it, with the help of a program called BalanceLog, and took off 44 pounds. My BP dropped from 140/90 to 110/70, with commensurate reductions in other risk factors. I rode nearly everywhere a whole chainring higher than I used to and set some PRs on my usual rides (at age 58), even though I wasn't particularly trying for speed.
Just as important, I felt a LOT better, had more energy, and people even told me I moved better. I'd get home at the end of the day and be pissed because it was too dark to go work in the yard, rather than ready to settle into the Recliner of Death. There's evidence of cause and effect, too, because I gained back 20 last winter, feel 50 percent worse and my BP and triglycerides are headed up (cholesterol is genetically low, never over 160). Do what you can to get that weight off and you'll be in a lot better position.
As for the heart rate...I'm on a drug that limits mine to about 120 (previously, I saw 160-165 regularly). It's a PIA at times, but you learn to deal with it. I can ride all day long at whatever pace I'm in condition for, but I have almost no reserve--if I have to sprint, climb or pick up 2mph, I'm just dead in the water. I go anaerobic in seconds. Soon as I slow down, I recover.
 

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Glad you found out about it now since you can do something about it.

We had a guy at work that was about 27. Rode to work every day, about 30 mile round tripalmost every day of the in sun, rain and snow. Had a nice Merlin mountain bike and a Merlin road bike. He lived to ride. His roomate found him dead in bed one morning. It was a genetic defect in his heart that went undiagnosed. Not sure if his was treatable or not.

Good luck with your treatment. Don't want to hear about anybody else going out that way.
 

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True story......
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A guy that I raced against (and who always kicked my a$$), was told by his doctor to take it easy until he could have some minor surgery to fix a smalll problem with his heart. Being a macho guy, he continued racing, without any problems, until one day, he pulled out of a race halfway through it, went back to his car, and died.
 

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Yep, dying young is a drag.

We all know stories of fit people who died for no previously apparent reason and stories of 96 year old, overweight smokers chasing the nurses aides around the home. For me, chasing symptoms and correcting risk factors detracts so much from the joy of daily living that it makes getting old, when I'll likely have more symptoms and risk factors, look rather unappealing. So I avoid doctors, exercise regularly, and try to eat some healthy food every day.

I've made it to 57, so it's too late to die really young. I'm not ready to fold my last hand, but I'm no more ready to start the cycle of taking a one drug to fix the side effects of the drug that fixes something I didn't know was wrong with me til a doctor ran some test. Is a fit young guy dying after a bike race more of a tragedy than a fit young guy afraid to raise his pulse for the last 40 years of his life?

In the words of Redd Foxx. "All those people don't smoke, don't drink, don't chase women are gonna feel awful stupid when they're 80 years old and dyin of nothin."

YMMV - these kind of questions are more personal than saddles!
 

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If its on the Internet it must be true

Think about what you are doing. Your Cardiologist, who has completed 4 years of college, 4 years of medical school, 1 year of internship and 2 years of residency and has been presumably certified by his peers as an expert in heart disease, after examining you and doing numerous diagnostic tests, has determined that if your heart rate exceeds 120, you risk having a heart attack or stroke and dying. In response to that you have asked for a second opinion from total strangers of unknown training, education or experience over the Internet. Sure its okay to get your heart rate as high as you want, if you believe in the Darwin theory.
 

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I would Highly reccomend the book "Before the Heart attacks" by Robert Superko. You need to read it. I wish I had years ago. I only found out about it a few months ago. I had a heart attack out riding one day and didn't even know it. I'm only 42. I felt something out of the ordinary so I went to see my doc. He sent me straightto the the caridologist and they did a cath, and they put in two stents and told me I needed by-pass surgery. I had a quadruple by-pass the next day. I completed all my rehab with flying colors. For me, my target heart rate was 142-167 at the end of my rehab. Of course, they have you all hooked up and monitoring you very closely. It has been 8 months since my surgery and I'm as good as new. I currently ride every other day about 30 miles each time. My normal loop has some pretty good climbs in it so the heart gets a pretty good work out. Get the book and do a lot of research yourself and don't be afraid to get a second opinion .
 

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Discussion Starter · #12 ·
Thank you all for the CONSTRUCTIVE posts and feedback,
 

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Discussion Starter · #13 · (Edited)
PJay said:
And exercise is very protective. But we don't know the time span that you have been cycling. I would guess at least a few yrs from your RBR membership time.

So you might be in the small group of people with a strong hereditary component to heart disease. And/or you might have more "cynical hostility" than the average person. Your response to the attempt at humor would go along with this possibility.

Look up "cynical hostility" on the web, and see if it sounds like you: suspicious of others' motives, believe everyone is out for themselves, and this mindset gets you angered often. The problem with this worldview is that when your blood pressure goes up in response to things you experience during the day (many things will make a cynically hostile person get irritated), it stays on your mind a long time and provokes your cardiac system to stay in the agitated, elevated state into the night.

The theory at this point is that this may cause damage to the cardiac arteries, leading to higher blood pressure as well as arterial damage - arteries develop "scar" tissue that clogs the artery.

If that is part of the whole problem, you can get a book on recognizing and modifying this personality style, or work on it with counseling.

They used to say "type a" people were more prone to heart disease, but they have figured out it is the cynical hostility part of the type a profile, not the other components such as always feeling time-pressure and being driven to succeed. So the good news is you would really just have to target the cynical hostility if this is the case.

Please don't jump on my case for making any of these suggestions or sharing any of this evidence or theory. Good luck.


FU buddy I'm not cynically hostile!!!!! :mad2: and I'm not easilly irritated :mad2: :D
 

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Discussion Starter · #14 ·
Holdem said:
Think about what you are doing. Your Cardiologist, who has completed 4 years of college, 4 years of medical school, 1 year of internship and 2 years of residency and has been presumably certified by his peers as an expert in heart disease, after examining you and doing numerous diagnostic tests, has determined that if your heart rate exceeds 120, you risk having a heart attack or stroke and dying. In response to that you have asked for a second opinion from total strangers of unknown training, education or experience over the Internet. Sure its okay to get your heart rate as high as you want, if you believe in the Darwin theory.

Obviously I'm not going to take any advice here verbatim. :rolleyes:
 

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Discussion Starter · #15 ·
etops said:
I would Highly reccomend the book "Before the Heart attacks" by Robert Superko. You need to read it. I wish I had years ago. I only found out about it a few months ago. I had a heart attack out riding one day and didn't even know it. I'm only 42. I felt something out of the ordinary so I went to see my doc. He sent me straightto the the caridologist and they did a cath, and they put in two stents and told me I needed by-pass surgery. I had a quadruple by-pass the next day. I completed all my rehab with flying colors. For me, my target heart rate was 142-167 at the end of my rehab. Of course, they have you all hooked up and monitoring you very closely. It has been 8 months since my surgery and I'm as good as new. I currently ride every other day about 30 miles each time. My normal loop has some pretty good climbs in it so the heart gets a pretty good work out. Get the book and do a lot of research yourself and don't be afraid to get a second opinion .

Thank you:)
 

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Gazoo said:
Hi all,

Only 38 but I was just diagnosed with a mild ischemia--blocked artery-- going on many drugs and no angiogram for now.

Anyone else here in my situation?

How about max heart rate?

My cardio is overly cautious and anal and feels that going over 120 BPM is a risk.

I've seen other places that reccomend different rates etc.

Anyone else here in my situation??
Here's my take. Personally, I would not stop here if I was you. First of all, "mild inferior ischemia" on a nuclear stress test is not definitive either way. May well be a false positive and you would be labelled incorrectly as well as unnecessarily limiting your exercise regimen for no reason. You are only 38 and will need life insurance, health insurance, etc for a long time. A positive stress test with no further evaluation is a huge red flag for insurers.

IMO, no 38 yo should be told that they have a potentially serious condition and then sent on their way with no further evaluation. I would ask for further testing.
 

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Discussion Starter · #17 ·
pagstx said:
Here's my take. Personally, I would not stop here if I was you. First of all, "mild inferior ischemia" on a nuclear stress test is not definitive either way. May well be a false positive and you would be labelled incorrectly as well as unnecessarily limiting your exercise regimen for no reason. You are only 38 and will need life insurance, health insurance, etc for a long time. A positive stress test with no further evaluation is a huge red flag for insurers.

IMO, no 38 yo should be told that they have a potentially serious condition and then sent on their way with no further evaluation. I would ask for further testing.
I hear ya!!

Unfortunately there is no other really definitive test other than an angiogram...

and paradoxically there is a higher risk for complications with young people so angiograms are out.
 

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I think maybe your cardiologist may want to A) get you on meds ie.. a beta blocker and aspirin therapy and B) give your heart time to develop collateral circulation (this is the formation of small blood vessels that bypass the blocked/narrowed portion of the artery and take over, in part, getting the nutrients to the muscle) Young people with new onset of cardiac disease are sometimes at greater risk of a cardiac event because they lack this collateral circulation that develops over time. As oppose to older people with severe blockages (even multiple blockages) who have over decades developed sufficient collateral circulation to nourish the heart muscle. Case in point- young guy drops dead outta the blue no one even knew he had a heart problem vs old guy survives massive heart attack requiring quadruple bypass. old guy has lots of collateral circulation young has none.
With meds and a resonable exercise program under the advise of a cardiologist you should have no trouble controlling your disease. I would encourage to research and ask questions. Skim this page for info
http://www.collateralthx.com/edu/angio_page4.html
this is more technical
http://heart.bmjjournals.com/cgi/content/full/89/11/1352
I don't know what meds he placed you on but try looking at this
http://www.rxmed.com/b.main/b1.illness/b1.1.illnesses/Ischaemic Heart disease.html
Just my thoughts. I would get more information before I ditched what my doc told me.
Take care of yourself!
 

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Gazoo said:
I hear ya!!

Unfortunately there is no other really definitive test other than an angiogram...

and paradoxically there is a higher risk for complications with young people so angiograms are out.
Perhaps a second opinion? The way my cardiologist broke it down was that nuke tests are rarely definitive, while an angiogram is considered the gold standard.

I'm 37, active, 30lbs to lose, slightly elevated cholesterol and a tough family history concerning cardio problems. I ended up being evaluated for possible heart problems and had a nuke stress test. It was inconclusive and I was not happy. I couldn't have that hanging over my head at this age while I still seek to be active, so my cardio suggested the angiogram. We figured out who has the local expert at this type of procedure, he wasn't concerned about the age given the possible alternative, I had it and came out with a clean bill (no blockage).

It was certainly a nervous time, but the procedure was a piece of cake (they went in through my wrist not groin) and I appreciate having some clarity over what is going on in my body. Now, I have work to do, taking cholesterol meds and getting those pounds off, but I am not feeling like I am on the verge of a heart attack. I was before.

Good luck to you!
 

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Gazoo said:
I hear ya!!

Unfortunately there is no other really definitive test other than an angiogram...

and paradoxically there is a higher risk for complications with young people so angiograms are out.
Not true. Although angiography is still the "gold standard", alternatives do exist. For example, CT angiography has been developed within the past few years and in many centers is replacing invasive angiography for the diagnosis of blockages, particularly in low risk patients. This involves a CAT scan with the injection of dye through a vein, not an artery and is less risky than invasive testing.
 
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