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Essential Information For Cyclists | How Safe Is Your Heart?

Essential Information For Cyclists | How Safe Is Your Heart?

(panting) (heartbeats) – [Simon] If there’s one part of my body that I take for granted, it’s my heart. I’m used to knowing how fast
it’s beating having ridden and trained with a heart rate
monitor for many, many years. But I’ve looked at it
as a way of measuring my training and not as a
vital organ keeping me alive. – Swoons your heart rate. – But there are many tragic stories of cyclists suffering from heart attacks or cardiac arrest when out riding. Perhaps older riders
who’ve returned to exercise after years of living the
high life or young athletes whose lives have
tragically been cut short. And then there is a third
type, cyclists who have, like me, taken their hearts
for granted for years and years without a second
thought, but who then find themselves with heart arrhythmia
or myocardial fibrosis. Could that be as consequence
of their cycling? To find out, we have come
to meet a cardiologist with a specialty, and among other things, sports and exercise. Dr. Graham Stuart,
himself a former Ironman, runs Sports Cardiology
UK which is a company that provides advice, screening and assessments for athletes. So who better then to give us the answers that we’re looking for. How concerned should we be and what steps can we take to ensure
our long-term health? And then also, something that I’m actually really genuinely nervous about, I’m gonna undergo a screening myself to see whether I’m actually at risk as well. (intense music) (heart monitor beeps) (rhythmic synth music) Before we start though, let’s
recap some basic biology. A human heart is a muscle. It’s made up of four
chambers, two upper ones called atria, and two lower
ones called ventricles. The right ventricle
pumps deoxygenated blood into the lungs where it picks up oxygen returning then to the left atrium, then pumped from the left ventricle to supply the rest of
the body, brain, legs, et cetera, with that
freshly oxygenated blood before returning to the right atrium. Now each heartbeat is triggered by an electrical impulse
from your sinoatrial node and the rate at which it beats varies depending on input from your brain. Now what about when things go wrong? Well, a heart attack is
when the supply of blood to the heart is suddenly blocked, most commonly as a result
of coronary heart disease which is a build-up of cholesterol. A cardiac arrest is a sudden
loss of heart function that usually occurs as a result
of electrical disturbances to your heart rhythm called arrhythmia. A heart attack can lead to
cardiac arrest, but as we’ll see, other factors can cause
arrhythmia as well. Now could extreme exercise
increase the risk? – If you have an underlying predisposition to a heart problem, yes it can. In general terms, extreme
exercise is good for your health, but there is an element
of common sense here. So, if you’re under-trained
and you push yourself too hard, that’s not
going to do you any good. If you’re doing long-term,
extreme endurance exercise, the evidence seems to be
that for the professional athletes actually you live longer. What’s not clear is where
there is a sub-group where it causes harm and we just don’t really know enough about that, and we know above a certain level of
exercise, just as you’re, no matter how fit you are, if you run down the span of Wales over
five days, you will ache. – [Simon] Yeah. – And I think the same
is true with the heart, that above a certain level of exercise, you will put the whole
physiology under strain. And if you look at
somebody’s heart after that, you will find that the
right ventricle is enlarged, the left ventricle is small
and most of these changes get back to normal over a few days. Sometimes it takes a few weeks, but if you do a biochemical
test, a blood test, you’ll find that the level of a substance that’s actually called
troponin is elevated… – [Simon] Ah, yes, that’s
what I was worrying about. Does my heart show signs of
damage following 27 years of riding as fast as I possibly can? Now, screening isn’t
gonna show everything, but it will show most things and it starts with taking my medical
history before then having an ECG which tracks and monitors the electrical signals
produced by my heart, and then finally and echocardiogram, which is a type of ultrasound scan, therefore using sound waves to create a moving image of what’s
going on internally. (heartbeats) – When you are exercising,
have you ever had any episodes of chest pain or a racing, inappropriately racing heartbeats? – [Simon] No. – So, your ECG shows a typical athletic variation called Rd repolarization. So there’s your heart. Now what I’m gonna do is get you to turn on your left hand side
and put your left hand, left arm behind your head
and you’re about to hear a squirting noise and that squirting noise is bouncing sound waves
off red blood cells as they cross one of the valves. (squirting sounds) So that’s crossing the pulmonary valve. And there, so in this area, for example, I’m looking for a hole in the heart, and that’s the blood vessel taking blood, blue blood, out from the
body up into the liver. And what I want you to do in
a second is to give a sniff. (sniffing) Now you see what happened there? The blood vessel went from
being 24.6 millimeters to being that size which is 6 millimeters. (synth music) – Before we get to my results though, let’s tackle those two
other important questions for older riders returning to sports, and then for younger riders who might be at risk of sudden cardiac death. Right, so, perhaps then we could talk about three specific categories of people and firstly would be older cyclists who are perhaps returning to exercise having had a number of sedentary years. Is there a risk to
catching this cycling bug and then entering these
quite extreme events maybe after only a few months or
even a few years of training? – So, if your uncle had
a heart attack at 40, and your dad had a heart attack at 38, and you’re 35, you haven’t
exercised for 20 years, but you want to start riding your bike, you would be very well advised to have an assessment beforehand, and if you have that family history you should be having an assessment anyway. The most likely thing
would be that there was high cholesterol in your
family and that can be treated nowadays and in fact one of the
best treatments is exercise, but you’ve got to do that in
a graded, sensible fashion. You want to pick up, if you’ve got a coronary artery problem
waiting to develop. The analogy of your leg
muscles hurting after exercise, they hurt an awful lot more
if you’re poorly trained. And I think the heart probably
behaves in a similar way. I mean, go back to your
question about somebody who wants to, say somebody who listens to this said, gosh, I’m gonna
have to start exercising. If they haven’t exercised for a long time, so a typical middle-aged
man in like the MAMIL. You know it used to be the business men would be out in the
golf course, now they’re out on their bikes and they’ve
got all the technology. I would suggest that they
get themselves checked, and in fact if you go to gym, it will say on the machine, get yourself checked. The reason for that is
often the very type-A personality is really
wanting to be competitive, but their bodies need to
be gradually built into it, and they don’t actually know if they’ve got an underlying issue. So, I think that group
are well-advised to have a check-up beforehand, and
ideally by a sports cardiologist because it’s a specific
thing you’re looking for. So, you may say, well, is
there anything I should look out for that might be a red flag that I should then lead to being assessed. And probably the most important one is if you’re fainting while exercising. So if you’re running
along or cycling along and suddenly you just feel woozy, you fall off your bike or you faint, or you have to stop, that’s a red flag. It may be nothing to worry about, but certainly you need to be assessed. Slightly different is the people who feel that way immediately on stopping exercise, and that’s extremely common. So you do the Bristol 10K, you then see quite a few end up just
staggering across the line, then collapsing and then have a drink and they feel better, and
that’s just as your body moves from a high heart
rate to a low heart rate, your blood pressure suddenly plummets, you’re a bit dehydrated, you feel faint. That’s fine, frequent and
usually entirely normal. But if you’re running along, feeling fine, then you go down, that’s a red flag. – The second category,
then, would be young adults. There’ve been a number of
very high profile cases in cycling over recent
years, not huge numbers, but any one is in itself a tragedy, but these young people, supremely fit, talented individuals who die suddenly of cardiac-related issue. Is this something that we can give advice to younger athletes to perhaps learn whether they’re at risk of this? – The first point I would mention specifically with cycling
but with any sport is I would ask what
supplements are being taken. Some supplements that involve a very high caffeine dose can cause you problems. So that’s the first thing, supplements. Second thing is, is there a symptom the question was is there a symptom that they would have to be aware of that might be a red flag? Well, again, loss of consciousness or your heart rate suddenly beating inappropriately fast or chest pain. – [Simon] So even in young athletes. – Even in young athletes,
yeah, so the heart beating inappropriately fast is quite
common in young athletes who have a predisposition
to an abnormal rhythm and for many of these it
can be completely cured. So, if you were to screen everybody. Say you screened everybody of age 15, you’d find only a very small number where they had a preventable cause of sudden cardiac death,
but for that small number you could potentially save their lives. There’d also be an even smaller number where you picked up
nothing and they still had a potentially lethal cardiac problem. So, at a population level,
it’s quite difficult to justify screening. For any individual, it’s
much easier, because you may find that you’ve got
something that’s treatable. You have to bear in count
you may find something that will tell you you can no
longer do professional sport, and that for a professional
athlete can be their livelihood. When you yourself had your screening, you were aware of the
anxiety that it provoked. Now, thankfully everything’s fine, but it may’ve picked up something subtle. For example, a slightly
prolonged QT interval that may have said well you
have this potential condition and we don’t actually know what it means for you as an individual,
and therefore, you’re left with uncertainty and then
we say, well, we have to screen your children, we have to screen your parents, your brothers and sisters, and we don’t actually
quite know what it means. So, there’s areas of uncertainty, and that’s the difficult
part of screening. – [Simon] But I suppose
the comfort is that you’ve put it in the context and
that is that statistically the chances of something
happening are minute. – Exactly. – [Simon] Okay. On then to our third group of cyclists, those who have been riding
hard for many years. It’s results time. – [Graham] And your ECT shows some changes compatible with being an athlete. So, your heart rate is relatively slow. It’s not very slow,
it’s 57 beats a minute. You have a notch on your ECG there which is called early repolarization. Now that’s a very common
finding in an athlete, and you also, your
initiation of your heartbeat, the largest upstroke is actually on here. That little bump is ups,
large sub-stroke is there. Rise and drop logs, it would be there. – [Simon] Right, okay. – And that means that your heart rhythm is initiated from a
slightly lower position than is usual. These would all be regarded
as a normal athletic variant. Okay? In fact, in the absence of symptoms, you wouldn’t do anything
about any of these. The third component
was the echocardiogram, and there what I can tell you is that you have a structurally normal heart. In other words, there’s
no holes in the heart. There’s no abnormalities of the valve. Secondly, that the heart
is contracting normally, and that the heart muscle
is of a normal size. Now that’s where it’s
quite important to know how much exercise you’ve been doing. So, for example, if you
were at your peak training and you were training 20 hours a week, the heart muscle would
probably be a bit thicker and the heart volume of the left ventricle and possibly the right ventricle would also be a bit bigger
than in a non-athlete. So, if I saw a septum
of your heart muscle, which yours was, it was
nine millimeters up, so it was in the normal
range for an athlete or a non-athlete. If it was 12 millimeters and
you did no exercise whatsoever, I would be suspicious that either you had high blood pressure or that there was an inappropriate thickening
of the heart muscle. 12 millimeters is a
deliberately gray area. If it was 16 millimeters,
that would be abnormal. whether you were an athlete or not. – I’ve read a number
of articles with links to studies that suggest that there might be a long-term health
risk from extreme exercise, anything from cardiac arrhythmias
to myocardial fibrosis or coronary artery calcification. Now I’m not sure what
two of those three are, but you know it doesn’t sound good. So, what do you think on those three? – Right, well, the first
question, arrhythmia is, the short answer is yes, there is. We mentioned how your heart rate is slow, and actually your heart
rhythm is initiated from a slightly unusual
place, not very commonly seen in athletes, and
that’s because of the affect of long-term exercise. Athletes tend to have slower heart rates, and we talked about how that’s due to down regulation of the IKF channels, and also increased vagal tone. Now we know statistically
that athletes who do a lot of exercise, particularly endurance athletes have a higher risk of developing a condition called atrial fibrillation. Now atrial fibrillation is
a very common arrhythmia as you get older anyway,
but if you’ve been a long-term athlete, endurance
athlete, it’s even higher, and specifically it’s bigger athletes, as opposed to smaller athletes. So there’s probably an
atrial size aspect to this. We’re not entirely sure
of the reasons for this. There’s also genetic components. If your parents have
had atrial fibrillation, you’re more likely to get it. So somebody in my situation, I’ve done long-term endurance sport, two parents who had atrial fibrillation. I will almost certainly
get atrial fibrillation ’cause I’m tall and I’ve
done endurance sport. Probably higher risk
than somebody who hasn’t done all these things, but
there’s both the genetic plus there’s the behavior aspect to it. So that risk is probably, I don’t know, four or five times higher than somebody who didn’t do that endurance sport, but you have to put that in context that, undoubtedly, the overall
benefit of exercise outweighs a lot of that. So, by doing long-term exercise you reduce your likelihood of certain
cancers, bowel cancer, breast cancer if you’re
a lady, prostate cancer. You reduce your likelihood
of cardiac disease, degenerative cardiac disease
like ischemic heart disease. You reduce your likelihood
of developing diabetes, maturity-onset diabetes. You improve your lipid profile. You strengthen your bones. Lots and lots of benefits. So, you have a slightly increased chance of an arrhythmia disorder,
atrial fibrillation, but greatly reduced chance
of all these other things, and you live longer,
that’s increasingly clear. So, atrial fibrillation,
it’s an arrhythmia that is now imminently treatable in an otherwise healthy person. If you have an area where the heart muscle is not adequately perfused with blood, then you can get a scar. A scar is fibrosis, and
we know that sometimes athletes who’ve been doing the long-term endurance athletic activity will have an increased amount of scar on the heart and part of that I suspect may’ve been due to exercising when they’ve had a virus, and so you know that the
advice that if you’re achy, your muscles are
aching, you should not be doing exercise, and I
think that’s good advice for so-called myocarditis
because then you’re exercising a muscle that
may be inflamed anyway. It’s possible that
myocarditis while exercising might lead to permanent to scar, or it can lead to scar anyway. What’s not clear is
whether extreme endurance exercise can lead to scar. One of the ways we look
at the coronary arteries is we look for calcium
scores which are these blood vessels can get encased in calcium. They become thickened, and the plaques, which narrow the calcium-filled arteries, tend to be more stable
than the fatty plaques that you get from actually
having high cholesterol. So, we know that if you look at a number of athletes, there seems
to be an increased instance of coronary artery calcification, particularly in endurance athletes, but they don’t seem to
have an increased risk of heart attacks. Our hospitals are not full of ex-athletes having heart attacks. They’re full of smokers
having heart attacks, and people who are obese, and people who have not looked after themselves. (guitar music) – Well, that is another GCN video that’s asking us to
confront our own mortality, definitely a positive
take-home message though. And that is that exercise
is overwhelmingly beneficial to our health
although there are those of us out there that would probably be advised to seek medical advice on this particular subject perhaps because of family history or you’re part of that category of people
that is slightly more at risk either due to
lifestyle or your age. If you would like to see another video on a health-related subject, this time on stress and mental
health and how cycling can help it, then you can
click on onscreen now. I’m gonna go put a coat on.

100 comments on “Essential Information For Cyclists | How Safe Is Your Heart?

  1. I’ve rode bikes for 30 some years for fun or raced. Last year I was diagnosed with a condition that’s called vasovagal nocturnal syncope. The cardiologist says it could be related to pushing my heart hard over the years now paying the price.

  2. Quick point of order: if you're consulting with Dr Stewart in his private capacity, at Spire, he should NOT be wearing his NHS badge.
    If you're seeing him in his NHS capacity, no need to advertise his private work.

  3. Many athletes have heart issues because of their lack of magnesium and minerals intake before, during and after exercise.
    Gatorade is nothing more than high fructose poison; genetically modified, which the body cannot consume. Sugar is not a way to fuel a athletes body, but millions of people consume that garbage because of glorified athletes promoting the crap!
    The body needs pure sources of electrolytes, which can be purchased and added to ones water. The heart, which is a muscle, needs to be nourished by magnesium, in order to function properly.
    That too can be purchased in liqued form and added to ones daily water consumption .
    I have used the above method , along with the rest of my family with great success.
    We are all athletes and add both magnesium and minerals to our drinking water, especially when we are actively running, road cycling and weight lifting.
    If you're looking for a reputable, honest company that sells these products, I recommend Dr. Carolyn Dean's health products. They will change your health forever, and give your body what it needs in order to function at its highest peak.
    Once you read her writings on magnesium deficiency, you will be glad you did!

  4. Are those of you doctors? I don't think so. Please first contact a real doctor before doing extreme intense sports like cycling!

  5. Really nice work. Thanks for shedding light on this topic, especially for us older cyclists. A good book on this topic is, "The Haywire Heart". It is a worthy read for learning the symptoms of atrial fibrillation and other heart ailments of older endurance athletes. Thanks for producing such quality content!

  6. I have over 100,000 miles on my pedals at age 58 I did most of that between 27 and 52. I had several DUIs and had to pedal everywhere. I did 25,000 in three yrs three times. As I got fit I realized I liked cycling, and would go for centuries on a whim. I would pedal 75 miles to have lunch somewhere then pedal back. My heart is ready, even now I go out for 45-50 and play a round of golf later on. Pedal hard.

  7. Cycling is never good for your heart. You could get heart attack just from the bike parts prices alone.

  8. Does Q10(Ubiquinol) help protect my heart? I saw some racer taking it,I wonder if I should get some too.

  9. 24/7 wrist HRMs (like my Forerunner 935 or the Fenix that the doctor is wearing, or any of the similar Garmin models) with daily stress scores are fantastic. I didn't even think that I would use the optical HR and I still use the ECG strap for cycling sessions. Having 24/7 seemed cool for sleep monitoring and automated recording of resting pulse but the best thing that I didn't expect to gain from is the daily stress score. It really helps me remember to rest if I get wound up on a long hill ride (as I do twice a week) and then get "honey do" adrenaline that same day before I rest up enough. You want to rest up a bit more any time your session stress score is higher than usual and sometimes the next day as well if your resting pulse doesn't come down to normal. The Forerunner 235 and 245 also do cycling and 24/7 HRM, sleep and stress scores. When I last checked (a year ago) no other watch packed all of those features with both BLE and ANT+ sensor compatibility. However, the older Garmins do not all support BLE (I think the 235 and 735 lack BLE sensor support). Those communicated with your phone through Bluetooth but do not support BLE sensors. OTOH, all of the best sensors support ANT+.

  10. As a massive heart-attack survivor and former hard-core martial artist and recreational cyclist – I found your video (and all your videos) to be extremely informative!
    Thank you for sharing!

  11. I have LV Non-Compaction Cardiomyopathy w/right brachial block. Really its just a bunch of words meaning "heart disease". I also have a diffibulator installed. Heart disease makes riding difficult due to a lack of stamina. I have searched and searched for info having to do with people like me who ride with heart disease. Mostly just find info on how cycling helps prevent heart disease.

  12. Or…..get an electric bike, chill out, and don’t strain and wear out all those vital organs…Lol

  13. There's a good book on this subject called "The Haywire Heart," which came out a couple years ago and covers this topic in great depth.

  14. Great video thanks guys I am 45 years old going back to cycling I will use this information and go to get checked before I start.

  15. Excellent video, in particular the description of heart function prior to the cardiac specialist running through his spiel – I don't think I've seen heart function so clearly described before.

  16. The beginning if this clip has me on the floor. 😂😂😂 Fact is, it's not cycling but HOW you push yourself while cycling. I've been cycling, not racing, for 35 years and my heart actually strengthened. If you find yourself breathing hard and feeling light-headed, you're outside your standard operating range. Take it slow. The headstone on your grave is no trophy. 🤔

  17. Wonderful video. My own club was talking about this last week, and awareness goes a long, long way. My own recommendation? Go and get your yearly physical and talk to your physician about your concerns. It doesn't hurt!

  18. Safest thing to do for your heart , is blast hell out of it, I was a speed skater harder than cycling , the more yiu bust your heart the better it works , no one hardly uses theirs, wusses

  19. Arythmias can also lead to blood clot formation, and those clots can possibly produce a heart attack, even in the absence of any disease in the veins or arteries. Been learning about this stuff myself lately. Had a kidney stone couple of months after my last Ironman, and then the EKG showed an atrial flutter, and I’ve always had a low resting heart rate in the high 30s-low 40s. Also found some scar which the cardiologist suggested could have been from a virus, just as in the video. They did an ablation to correct the flutter and restore normal sinus rhythm, but it came back a year later. Very timely video for me. Thanks much.

  20. Yeah that's great news to hear that long term extreme endurance exercise is good for your health and that it helps you to live longer. "Sudden cardiac death" ?… Wow one of the best treatments for cholesterol is exercise. Fainting while riding? That's is called a stroke. High caffeine can cause heart problems. Abnormal cardiac rhythm. Riding hard for many years the results , notch on ACG, normal athletic variant. Twenty hours a week creates thicker heart muscle right ventricle will become thicker as well. I can truly attest to the slower vagul tone. Atrial fibrillation is some thing I need to look more into. The overall benefit of exercise surely outweighs the risks. So, in summary don't exercise while sore. Calcium sores are narrowed by plaque. Once again an informative video by GCN.

  21. I was pretty much hanging one every word the doctor said. I cycle about 34 miles 2 to 3 times a week, and I always wonder if I'm pushing myself too hard or not. Meaning my heart to hard. I can physically do it without a problem, but I have always wondered if it's good for my heart. I really appreciate this video. I am happy your heart is good!

  22. For many heart attack victims, their first sign or symptom was a heart attack and about half of the people who survive a heart attack had the same risk factors as those who died from theirs!

  23. Anyone that runs the iron man should not be giving advice to anyone on any subject, as masochism as a base for ones identity cannot be considered a positive attribute .

  24. Bravo…this was one the best, and valuable videos i've seen. Following the Clint Eastwood words…"a mans got to know his limitations"…yet on we fly, push harder, and not deal with our limits. To do is always good….to OVER do is the danger, and accepting that. 65 now, not a cyclist body, but get the miles in…I had to walk 3 ugly grades on one ride earlier this year….upset, ego…all that male thing came at me…then, I said, even with that need to walk a bit…I still did finish a hard 35 mile ride. Lesson learned for me was to enjoy the ride, and if I don't make any one or other hill is not the end of it. Rather be up on the bike, than down with the daisies. Thanks for this reminder to us all.

  25. Great video guys.
    As a former pro cyclist who still now competes (well) into my 50s, I now have some heart issues. Your cardiologists words were somewhat reassuring.

  26. Very good information on an increasingly relevant area of life. As a doctor i can vouch for the benefits of exercise , anyday and if one unfortunately even has to give up an ambitious plan of competitive training, keeping oneself fit and engaging in some other safer sport is also equally good…having said that , cycling as a sport, recreation, hobby or a lifestyle, is like water , and takes the shape u wanna give it..😄never stop it.

  27. Very informative in my experience I actually find cyclists who cycle at a decent level very helpful on fitness tips and general health tips.

  28. At 6:58 of the video there is a device on the docs table (black with two silver pads), what is it and can you elaborate on how the doc recommended to use it?

  29. thanks so much. I suffered Afib a few years back after 40 years endurance sports: Cross country skiing until 25 and Cycling since I am 10. I am 1.97m.
    My Afib was induced when my parasymphatic nerve system took over at resting the night or the day after a longer ride, never during cycling.

    For all seasoned large athletes with atrial fibrillation and healthy heart otherwise get an ablation AQAP!
    I was back on the bike after week 2, and five years free of any illness ever since..

    Was at the wrong cardiologist who put me on beta blockers and arrhythmic drugs firstly… Ablation after 1 year of pain and suffer from the meds, without being able to do daily works, not to talk of doing any sports that lead even to a light depression.

    After Ablation I got my life back!

  30. Interesting that there is no mention of HCM, If 1 in 500 people have it I would think it might bare mentioning. It certainly would have made a difference to me having this brought to my attention earlier. Good information regardless. TY

  31. Interesting stuff. I will say though that, of the three now middle aged high level triathletes I know personally, two have had heart attacks, and both of them know friends in the sport who have had fatal heart attacks. Maybe cycling isn't a problem in and of itself no matter how hard you train, but the massive strain of training in three disciplines just might be. Just my 2c.

  32. When I was 16 my lowest BPM was 38, I'm 17 now and its 47, I do downhill mtb and used to run cross country

  33. Two years ago, I had arrhythmia symptoms and got them investigated. It was a worrying time, but my specialist provided reassurance and help through the type of investigation discussed in the video. My condition was identified and happily, the irregular beats and palpitations have stopped, with my ticker returning to normal (yes, as if nothing had happened!). I found this video very helpful to refer to other riders I coach, particularly in the advice around risks from viral illness – which is where I believe my issue started. I’m fairly sure that I had a particularly nasty virus and that it affected me long after the symptoms of it disappeared. Well done Si and the GCN team for bringing this issue forward!

  34. Fantastic video guys, one of the best you've ever made on such an important subject. makes me feel bad for Dan though :C

  35. I had been riding for over 30 years. Currently 65 years old. The last 20 on the road. I began having chest pain at the beginning of rides that would slowly go away over the first 10 miles of a ride. The rest of a 50 mile ride I felt good without pain. I brought up the pain with my family dr and he sent me to a cardiologist that had me do a treadmill stress test. The treadmill just didn’t stress me the way cycling did. I tried to explain that but they told me not to worry and go ride my bike. Move forward three years and the pain was lasting longer into a ride. I decided something need to be done. I found a cardiologist that was also a cyclist. She listened to me and felt I probably had a artery blockage somewhere that needed to be looked at. I was in the cath lab the next day. The cardiologist found several blockages from 65-95 percent. Shock of shocks to me a long term athlete. She decided not to attempt a stint without additional backup heart surgery options available. The next day I was carried to Atlanta Piedmont’s cath lab. They placed 4 stints in my heart arteries.

    The Piedmont doctors told me the long term cycling created additional heart arteries that were also providing additional blood to my heart. I was very fortunate to find the right doctors at the right time. I was definitely living on borrowed time. I now back riding and slowly getting back in shape. If you are having chest pain during a ride, don’t wait around. Find a cardiologist that will listen and get checked out.

  36. Great video. And the doc is also a great guy. He explains the most important points in an understandable way. Thanks!

  37. My author broke 15 years ago. I probably survived because of my good condition I received from cycling. I still cycle, not as strong as before but it helps me live a good and active life.

  38. I very much enjoy GCN's health-related pieces (and everything else), and this one was simply outstanding. You guys are wonderful!!

  39. Hi,I do occasionally maybe once every 4 to 5 months where my heart rate does suddenly beat fast can happen at the gym even when not exercising.Will last for about a minute or 2.I have had a CGE test all normal, should I still be concerned?

  40. Is cycling harder on the heart than running?

    I am new to cycling and find my heart beats faster cycling at a comfortable breathing rate than it does when running at a comfortable breathing rate – but I don't know if that's me being better adapted to running after doing a lot more of that than cycling.

  41. I would think a treadmill stress test would be helpful, as the third useful test at the clinic.

    In my experience, the cardiologist can suggest the expected safe zone for you starting conditioning.

    The exercize heart monitor helps.

    ..if walking build up to 20 minutes or 40 minutes 3x a week walking without taking a break, even if walking slowly, for example, a stroll.

    ..and up to a zone for training with sprints or for hillclimbing with a bicycle, for example.

    There are exercize zones and resting zones that are general recommendations by age, as well.

  42. In USA, we say cardio myopathy for a scar? It is death of heart tissue.

    It is possible to get cardiac coexzymes within 24 – 72 hours of cardiac incident,

    I understand this is highly accurate. if you feel symptoms of a cardiac incident or, as he says, you collapse, then all three cardiac coenzymes tests over the next 24 – 72 hours can be the helpful diagnostic.

    Fibullation? I don't know. I do know it is important.

    I do know more than a few hard exercizing and hard working men have it, and had to "retire".

    I know one of the men well enough he told me his living through the worst of it, was touch and go. He no longer does strenuous work or strenuous activity. He gradually got up to walking in what you might say is a casual stroll.

  43. I had heart failure and stage II kidney failure due to anaphylactic shock, while serving in the U.S. Army. It got worse before it turned around, I attribute to avoiding nitroglycerine tablets and starting nitrospray as needed, that and I started visualization meditation with a specific kyriya position face down.

    The change in prescription and the "alternative medicine" technique recommended because I had only been getting worse. In fact, the cardiology service RN introduced me to meditation by a guided meditation session at the hospital clinic.

    The echocardiogram showed atrial valve fibullation, mitral valve prolapse, thickening of the heart wall and some amount of enlargement.

    I had been successfully athletic, and so, I put my bicycle frame on the wall in my room to admire it and remind me I am a healthy person.

    I gradually got up to 20-minutes slow walk 3x a week to optomize my heart health.

    My cardiologist was satisfied. This was my new personal best.

    I had so many years of experience, along the way, I thought I would share some of that experience here.

  44. I suggest a treadmill stress test can be a helpful clinical exam.

    There is a standard protocol, adhusted for atheletes or adjusted if symptomatic.

    The cardiologist can, then, more decisively recomment the "zone" for exercize and the "zone" for resting heart rate.

    There are also general guidelines for "zone" by present activity level (mild activity, moderate activity, or sedentary) and by age.

    The heart rate monitor, then, becomes a more highly useful tool.

  45. Thank you for this great video. Please consider doing more on how to modify heart rate training as we age to maintain a healthy balance. 5 hrs @ 70% max? 10hrs of 85-90% max? Very few cardiologists know how to effectively train aerobically. They are reactive to people that are sick.

  46. Do your research. It is now coming to light that cholesterol levels have little to no baring on the risk of heart disease or any other disease for that matter. Simply google cholesterol myth to see opposing opinions and evidence……Top Cardiologist Exposes The Great Cholesterol Con .

  47. Yes it is safe , i got very ill at 50 "heart problems" cellulitus , decided to commit suicide by over training (suicide is for wimps) but keeling over running is ok .

    Cycling just doesnt do that much fur cardio compated to my sport shirt track skating

    So Id do 80 miles to beach run two hours a night attacking all time , you dont die you get better .

    Dont listen to medical tossers look at them in video not fit , cant do it themselves , at 60 i can tell you as they drop like flies , after a cack life , Im still fit , pulling birds better shape than ive been in .

    Pour olive oil in your left ear , vinegar in right ear , thats the answer , not this crap , your lungs fill up with calcium you do not have heart oroblems . Medical people talk shit

  48. Great video bringing awareness to this topic. I am a 6ft 10in former rower, who still trains. I developed a-fib 18 months ago in my mid-30s. Various treatments later (DC cardioversions and an ablation), I am back training and am hopeful of a full recovery. The more I train, the better I feel. Anyone going through the same thing, keep your chin up.

  49. Why is it that these "specialists" know so little about their subjects?
    For example, AF is ended by taking the supplement taurine, and calcification anywhere is ended by taking vitamin K2.
    All they seem to be interested in is subjecting you to their expensive technological toys, that in the end tell you absolutely nothing.

  50. I have purchased Apple Watch, just interested to see about mine heart rate. Set alarm for over 150(not much worried in here ) and Lower then 45. On bike I get over 150, even over 170. Expected. Night time is usually @ 45.
    Thanks for such topic video.

  51. Check out the uk charity CRY which provides heart screening free to identify heart problems in the young people which would normally go un detected which if not identified can result in premature death , the charity raises funds and provides local screening, it's supported and has patrons from some of our top sports people

  52. Hard interval training might be correlated with fibrilation. I ended up convulsing on the floor once. Very scary. But when can you do? Start backing off and you're definitely stuffed. I take the view that you're using less total muscle than in running, so you're generally putting less load on your heart.

  53. I heard a cardiologist say that he'd never seen an exercised-induced heart attack, but that he'd seen hundreds that were caused by the lack of exercise.

  54. I did the first ever 24 hour mountain bike race with had a teammate who later found that he had a heart murmur.

  55. well i died, so i guess it was not. but on a positive note, here in hell there's a very good wi-fi. But no climbs or strava.

  56. Very good video.
    But it doesn't really cover all the bases.
    There is a group of heart decisis covering changes to the heart tissue called cardiomyopathy.
    I'm 51 at 50 I (after 30+ years of various kinds of exercise covering marathon, triathlon and endurance bike riding) I suddenly experienced 220 bpm heart rate and dramatic loss of blood pressure after my normal run. NO PAIN. I ended up with a diagnosis of ARVC (arrhythmic right ventricular cardiomyopathy) which kills if not found, and an ICD to bring me back if the worst thing happens.
    Besides that I'm "banned" from any kind of future exercise that puts strain on my right ventricular.
    I have been predisposed for this, but it took 50 year to develop, and it debuted in just one exercise.
    Looking back in my traning data I see that I was unexplainable loosing speed over time. That should have told me that something wasn't right.
    I was lucky.
    Train wisely. Listen to you heart. Stay safe.

  57. Those benefits they mention are not specific to extreme endurance compared with less extreme athletes. They would be realized just as much by 5 or 10 km run as a marathon.

  58. Thanks from a 65-year old cyclist who recently developed exercise-associated atrial fibrillation. Learned more from this video than my weeklong review of the literature on the topic.

  59. 10 years ago I was diagnosed with dilated cardiomyopathy. 
    I was discharged from the hospital with ejection fraction of 12 and the doctor was crying when she told me I had 3 months to have heart transplant or else I am 100% sure to die.

    Yesterday I commemorated that date with a 108 km ride. :):):)

    This is my experience with heart conditions and bike riding…

  60. Interesting. 20+years ago I was running and cycling competitively, I developed some form of exercise induced tachycardia and ended up seeing a cardiologist and soon after, the only way to exercise was with the use of beta-blockers… It was around the same time that professional mountain biker David Baker of Raleigh and GT bikes fame was forced to retire with heart trouble

  61. Heart attack is due to blockage from CALCIUM, not cholesterol. Cardiac calcium score test is what determines the risk and blockage. Cholesterol is NOT a risk factor for heart disease. Enough about the cholesterol lies and hoaxes.

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