Recent headlines - Heart complications

Triathlon -

Recent headlines - Heart complications

Recent headlines - Heart complications
With the recent news events that came out with regards to a middle-aged cyclist who passed away on a ride, I wanted to write an article on possible heart complications in sport.   This article is of my own first hand experience and friends who have dealt with heart conditions and complications over their sporting lives.
It is important from the outset to know that fit and active people are susceptible to lifestyle diseases and other conditions that are hereditary.   When I was growing up I was fortunate to run for Takapuna Harrier Club, that had many World Record holders as well as Olympians.      One of the members was Euan Robertson, who raced for New Zealand at the 1976 Montreal Olympics at the 3000m steeplechase.   Not only did he finish 6th at the event, he set a New Zealand record which stood for 8 years.   Euan was a large part of the club and stayed a very active runner leading the top open Men’s and Junior running teams as we went through our winter running months.    Euan was out running with friends on a standard long run one weekend.  After not ‘feeling well’ and resting on the ground, Euan had a major heart attack that was fatel.     Although others did not know it at the time Euan had recently found out that his biological family had a history of heart attacks, early in life.
For myself, I recall sitting at an awards ceremony for the Prime ministers Scholarship, which is awarded to young talent who had performed better than top 15 at World Championship Junior level.  I recall being very hot and un-comfortable and I turned to my Dad (Barry Larsen) and said, “Something doesn't feel right with my heart”.    At the time Dad was coaching me and we took my pulse.  Sure enough it was very erratic and well over 160 beats per minute.    This was very unusual, as a 19 year old, you are feeling pretty indestructible and given my resting heart rate was much closer to 50BPM, to be sitting around at that level was a big concern. Neither of us had any idea what could be causing this to go wrong, however I went off to the doctor who immediately asked me to go to the emergency room.   After several hours waiting, I was finally able to see a cardiologist who immediately diagnosed my symptoms as atrial fibrillation (AF) a medical term for a heart beat with no distinctive rhythm.    Fortunately for me, the condition could be fixed after a couple of weeks of medication and a couple of months rest.  After a re-visit and a myriad of tests, I was able to continue pursuing my triathlon carrier but now had to pay a lot more attention to my heart.    

As I was to learn in time to come, being in AF is dangerous for good reason.  The heart muscle pumps blood around your body.   In the most simplistic terms, if you are in AF blood is not being pushed around the body as it usually would and this opens the risk of blood clotting.    If a blood clot does form and is pushed around your body, it is the cause for a heart attack or a stroke.     

Every year you will notice a very small amount of young, fit and healthy people passing away either, during or immediately after very intensive exercise, due to seemingly unknown reasons.   In the vast majority of these cases there are underlying heart complications that the athlete is not aware of and when put in certain, otherwise normal circumstances, the condition can lead to death.

For my own situation I have a golden rule and then a series of triggers to monitor and avoid in order to control my AF. 

Golden rule 1: 
If I go into AF – stop immediately and go directly to hospital.   Any excursion when in AF creates a higher level of risk for blood clotting.
High-risk activities – activities that will trigger AF on their own:
  1. The artificial sweetener used in Coke Zero almost immediately flips my heart into AF.   Diet Coke, and regular Coke do not have any impact
Moderate-risk activities – activities that in conjunction with low-risk activities that can put me into AF:
  1. Any session that is a maximal effort, for a short period (spiking my heart rate very high).  Examples, 1500m, 3000m races.   Track sessions where I am doing 400m or 1km interval sets a max
  2. Lack of sleep, disrupted sleeping pattern for a prolonged period
Low-risk activities – activities that will combine with a moderate-risk activity, to cause an AF episode:
  1. Elevated stress levels
  2. Too much caffeine
  3. Too much alcohol
  4. Overloading on food/ supplements that have very high levels of potassium
  5. Lack of hydration
  6. Too much caffeine

Fortunately the last time I have been admitted to hospital for a case of AF was in 2008.    For the most part that episode was caused by the fact that I was abusing all of my known ‘low risk activities’ as well as a lack of sleep.  What put me over the top was one celebratory drink one evening that was using Coke Zero rather than the regular variety.

My advise to all athletes would be to book at least one visit to a cardiologist to discount any anomalies in heart rhythm from the outset, as well as diving into your family history.     This is a great starting point.    From there it is about listening to your heart and body when you train and to be proactive on issues early, rather than letting things develop into much larger problems.

Written by Scott Larsen
Founds and Coach at Tri Edge

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