Heart attack -- advice?

You need to walk before you can run!!

If you are planning on running any time in the next year I hope your personal affairs are in order.

No cardiologist on the planet would endorse a return to running in less than 12 months.

If you claim yours is you sir are merely trolling.

Jeez, are you running 2:40's for the marathon?

Cavorty wrote:

day2day wrote:

hope you can slowly recover back to normal, don't be afraid to get second opinions from qualified doctors because two doctors contradicting each other is rather common

is my thinking wrong on this or would the max HR on someone over 60 be so low that your heart would basically be working at maximum all the time for any kind of decent pace, at even the best efficiencies? that's a lot of strain

Not from personal experience.

I'm 60 and haven't run all out with a heart-monitor on for a couple of years, but my top was about 170 then, and at the moment I'm doing steady runs 7:00 to 7:20 pace at about 126-130.

Based on a resting pulse around 42 - I'm running Z1 aerobic pace.

1955 wrote:

Let's see, as best I can:

1. No. In fact, he noted arteries were larger than normal (which for some reason he said was congenital, not a result of running).

2. Am not sure.

3. NA

4. Angiogram, followed by battery of meds to break up clots/plaque.

5. No.

6. Baby aspirin, lipitor, brilinta.

7. No stent (he actually said the artery was too wide to put a stent in).

8. I believe results at hospital were LDL 87, HDL 59, total 153

Well you're lucky, with the exception of having the MI. In 40% of cases the first symptom is sudden death. Also, given that it appears to be related to an pesky clot, any reason given to you as to the origin or cause? Before I'd do any running I'd probably have a stress test to ensure that you can run as close to your max age adjusted HR with no issues. If so then you're good to go. Your lipid profile looks pretty much ideal. Any idea as to what it might have been prior to the Lipitor?

Alcohol hasn't been mentioned once. Was this at all a contributing factor do you think? I frequently drink excessively and notice my heart acting up sometimes afterwards (could be the dehydration (?)).

Binge drinking can cause arrhythmia and is strongly linked to atherosclerosis, heart attack and strokes. He didn't mention drinking a lot, but it certainly isn't good for you.

Those are the levels when I arrived at the hospitals, before any meds.

As for the cause of the clot, they are testing for clotting disorders, but I won't know those results until next week. I kind of get the impression the docs are almost as surprised as I was, although the cardiologist stressed that he's had marathon runners and other in-shape athletes previously.

Yowser wrote:

Alcohol hasn't been mentioned once. Was this at all a contributing factor do you think? I frequently drink excessively and notice my heart acting up sometimes afterwards (could be the dehydration (?)).

Same here. Go through hangover/withdrawal and my heart bangs like a bass drum. And I'm over 60.

Still hobby jog several days a week, overweight though.

Run Doctor wrote:

You need to walk before you can run!!

If you are planning on running any time in the next year I hope your personal affairs are in order.

No cardiologist on the planet would endorse a return to running in less than 12 months.

If you claim yours is you sir are merely trolling.

Curious why you say this. I'm betting If his EF is above 40% he will be running within a few months. My EF was below 40 (moderate LV dysfunction) at the time of my AMI and there was real question whether I would run again. One week post AMI my EF had recovered to 55% at which point my cardiologist cleared me to begin running in cardiac rehab one month post event. LV function and arrhythmia risk drive that decision especially for someone with history of running.

amount of "damage" (ejection fraction), whether the MI was STEMI vs. non-STEMI (damage through the width of the heart muscle or not), how the arteries look throughout (not just at the point of the clot), all need factoring into recovery caution and time, as well as arrthymias noted or not, just has been said earlier.

Yes, you might return to running far sooner than one year from now, but getting the factual physical results through at least a dozen sessions of Cardiac Rehab. Please do get to Rehab, everyone is an "outlier" in Cardiac Rehab, don't let one tell you otherwise, it is your heart, your soul, your emotional and physical health, your LIFE!

And there are many cardiologists that will ok a return to running within a year, I know them right here in KC, and I have had the honor of working with them.

Yowser wrote:

Alcohol hasn't been mentioned once. Was this at all a contributing factor do you think? I frequently drink excessively and notice my heart acting up sometimes afterwards (could be the dehydration (?)).

Excessive alcohol consumption has been associated with heart arrhythmia, most commonly atrial flutter and fibrillation. A combination of the the irritant effect alcohol has on the heart muscle itself, and the resultant dehydration. best to hydrate well when on a bender.

1955 wrote:

Those are the levels when I arrived at the hospitals, before any meds.

As for the cause of the clot, they are testing for clotting disorders, but I won't know those results until next week. I kind of get the impression the docs are almost as surprised as I was, although the cardiologist stressed that he's had marathon runners and other in-shape athletes previously.

Well as stated previously, I'd not run, till you get the results of all the tests, and have a stress test prior to ensure there is no ischemic response at HR's approaching your age adjusted max. Probably a nuclear would be best as they can also measure EF at the same time and also look for flow abnormalities which I suspect are minimal if not absent, which will also give you an estimate of what actual damage may have occurred. That being said, assuming the damage is minimal, there isn't any significant coronary atherosclerosis seen on the angio and there's no ischemic response on the stress ECG you should be good to go. No need for a cardiac rehab program in that case. BUT, you will need to clear everything with your cardiologist.

I don't disagree on getting a stress test, but I do advocate for the Rehab, he's admitted to being VERY uncertain of how to proceed with exercise and even his wife is seeing his uncertainty. CR is not just about "old folks" toodling along with exercise, but also about providing concrete info on his BP and HR responses to exercise, his emotions (very important right now) and about dealing with his risk factors (which don't seem entirely clear right now). A supportive and safe environment for him to build up his exercise, ultimately his running, will be great FOR HIM, given what he's shared with all here.

vanjr wrote:

Medical mistakes are NOT the 3rd most common cause of death-not even close. I work in a hospital. I rarely see anything that comes close to a fatal medical mistake.

Right. Medical mistakes are the #1 cause of death. I can to into any hospital anywhere in the US and see these things happening constantly. Closing your eyes to them doesn't mean they're not happening all around you, but that you simply choose to close your eyes and your conscience, the only way you could possibly work there and be a part of it, plus doctors in general have terribly negative attitudes.

And 70 year old, how long would your friends have lived without a coronary stent? People commonly die due to a number of medical conditions while being treated for those conditions. That is why they are treated.

Obviously, since the medical interventions are what killed them, they'd still be alive. Yes, people commonly die due to medical conditions caused by improper medical diagnosis and treatments. That is exactly what happens.

Not sure if anyone is reading this thread any longer, but just a quick update:

- 2 weeks out from hospital.

- Have had f/us w/ cardiologist & hematologist

- Cardiologist is still optimistic I van run again, but only after a month of only low intensity activities. I can do slow walks -- adding no more than 1 mile per day per week (I'm now at 2m).

- Hematologist says no evidence of clotting disorder, and so he has no explanation for the clot, which he says happens about 50% of time. He did say, though, that the more active I stay, the better to reduce risk of clots, so he was happy to have me run again.

I still doubt I will do cardiac rehab but may do a stress test just to be sure before I start running.

Advice.. wrote:

Run Doctor wrote:

You need to walk before you can run!!

If you are planning on running any time in the next year I hope your personal affairs are in order.

No cardiologist on the planet would endorse a return to running in less than 12 months.

If you claim yours is you sir are merely trolling.

Curious why you say this. I'm betting If his EF is above 40% he will be running within a few months. My EF was below 40 (moderate LV dysfunction) at the time of my AMI and there was real question whether I would run again. One week post AMI my EF had recovered to 55% at which point my cardiologist cleared me to begin running in cardiac rehab one month post event. LV function and arrhythmia risk drive that decision especially for someone with history of running.

I am also puzzled at the remarks - in addition to my SCA etc I am told I have moderate LVSD, every time I see my cardio he makes a point of reminding me 'your heart doesn't beat as strongly as it used to'. However I am now actually several mins faster at 10k than I was beforehand...

I went through rehab and they had me running pretty much straight away if I recall. My rehab was delayed as I had a PTE after my bypass and in the end I got irritated and did my first run on my own, after a month of gentle MTB work on a flat canal path (no more than 110 bpm).

My heart surgeon told me I would get bored on the rehab programme and he was right but I stuck with it and it was reassuring to have them watching and monitoring me.

When I told them I had signed up for a 10k they did look a bit pale and suggested I should walk the hilly bit of the course. There have eeen a couple of heart related incidents historically at that point.

I am not suggesting anyone emulate what I did, we are all different and your health and risk aversion undoubtedly differ from mine!

1955 wrote:

Not sure if anyone is reading this thread any longer, but just a quick update:

- 2 weeks out from hospital.

- Have had f/us w/ cardiologist & hematologist

- Cardiologist is still optimistic I van run again, but only after a month of only low intensity activities. I can do slow walks -- adding no more than 1 mile per day per week (I'm now at 2m).

- Hematologist says no evidence of clotting disorder, and so he has no explanation for the clot, which he says happens about 50% of time. He did say, though, that the more active I stay, the better to reduce risk of clots, so he was happy to have me run again.

I still doubt I will do cardiac rehab but may do a stress test just to be sure before I start running.

Great to hear you're on your way to recovery. It sounds like the cause of your heart attack is still a bit of a mystery. If you don't opt for cardiac rehab you should get some guidance around HR range for running when you resume in a few weeks. Also make a point to include a solid walking warmup and cool down. Good luck!

Quick update: saw the cardiologist yesterday (5 weeks out). I've been building my walking up, to 4m per day; still not particularly quick but getting better.

I feel maybe 60%. No acute symptoms, although I periodically get twinges in my chest that worry me (but not my cardiologist). It's not that they are much, nor last long, nor are they anywhere near like the feelings I had when I was actually having the heart attack, but I can't quite get over worrying it will happen again.

Both the cardiologist & the hematologist say it is fine to resume running, assuming I do so cautiously, but I'm not ready mentally. I figure when I get through my walks feeling like I wish I was running, then I'll be ready. I'm guessing I'm at least another couple weeks from that.

Thanks to Birdlegs for asking (on another thread).