Heart attack and recovery
 

I'm 65 yr old male, mostly a read only forum member. Last month (July 5th) while out for a bike ride I had a serious heart attack. I got to the hospital fairly quickly and received a stent is what was described as 99% blocked right artery. Another artery the was 70% blocked was stented about 3 weeks later. I was put on a suite of drugs to lower BP, reduce lipids, thin the blood etc.

Before the attack I had been very active with regular jogging, cycling (in warmer months), walking and resistance work. I pretty much have done nothing physical since the event except some light walking. I just had an echo stress test and it had to be stopped at 6 minutes because my BP was high and EKG showed abnormalities. Not sure what the echo looked like - probably not good. Non stress echo they have said looked normal.

In general I feel pretty good but I really miss the active lifestyle. Is the anyone who has had similar experience? I'm supposed to go for cardiac rehab soon. Given my performance (or lack thereof) on the stress test I can't imagine there's too much I can do. Does one's performance get any better after rehab?

I would check with the doc first, and, if allowed, do all the "light walking" I could. We have a fellow on our trail system who walks 8 miles per day, never fails. Heart attack survivor, looks great.

Also, if you have any extra weight, lose it. Lower BP will result.

Sorry, never had a heart attack, so can't speak from experience.

Welcome to the post AMI club. I had a heart attack last December. I was lucky and thanks to my PA making an outstanding catch and a great team overall, I suffered very minimal damage. Recovery varies greatly with the individual and the location and extent of damage done. Having been active before your heart attack is in your favor, my cardiologist said it may have made a big difference for me.

The only advice I can give is to listen to your physician and cardiologist, go to cardiac rehab and work with them to set goals for yourself. Stick to the plan and don't give up. You are only a couple months out from your injury and recovery takes time. It may be several months to a year before the full extent of recovery can be determined. Obviously, your situation is unique to you but I do know of a number of cyclists who have returned to or even taken up cycling after a heart attack. Some have limitations but still enjoy the sport on a regular basis.

Be aware that depression is a common response following heart attacks. Don't take it lightly, let your doctor know. With my minimal damage and quick return to work and a "normal" lifestyle I didn't expect it, but it hit me fairly hard a few months after.

I had a heart attack while riding when I was 46 YO. However it was a minor heart attack and they didn't even fix the artery as it's a little one and would take open heart surgery to get at it. So that is a big difference right there. Then again, a minor heart attack is like being a little pregnant. :)

I started my recovery by walking also. After about a month I moved on to stationary bikes. About 3 months after the event, I got permission to start riding again. I use a heart rate monitor set to start beeping at 150 BPM to warn me to slow down. I have felt chest pain a few times when I've gotten my heart rate up around 170 BPM.

I've done about a hundred centuries since then and even a few double centuries. I can't go fast anymore but I can go far. I also walk 2 or 3 half marathons a year with my wife. We like to finish at around 3:30 hrs.

Problems: My first cardiologist was pretty clueless about exercise. When I asked what I could get my max heart rate up to, he said 105 BPM. What? And he meant it. He put me on a dosage of beta blockers that would seldom allow me to get my heart rate above 110 bpm. It was horrible for riding. When I suggested doing a stress test to find out when I'd start having problems, he said that I would fail a stress test. I said it wasn't a matter of if, but when, that I was interested in. I didn't get a stress test until 10 years after my heart attack.

Beta blockers, as I mentioned before, are prescribed to keep your heart rate lower. This is from resting heart rate to max heart rate. So they can really slow you down; might make you dizzy when doing things like standing up after sitting for a while; and can cause problems exercising on hot days. Think of your heart being like the water pump on your car. If the pump is working slower, it can't move cooling fluids as well. (I skip a dosage if I'm going to be riding in the heat). Oh! Beta blockers are also used as an anti-anxiety medication. Pretty nice as it also helps you not worry about your heart attack so much. However I noticed that I lost an 'edge' at work. I didn't worry about stuff so much including things that I SHOULD have been worried about.

Finally I got a different cardiologist and she was a marathon runner. We understood each other. Over the course of a couple of years she reduced my beta blocker dosage to a fourth of what it was. I had to promise to wear a heart rate monitor while exercising and keep an eye on blood pressure. We had to bump up a couple of BP meds instead. I didn't have high blood pressure before the heart attack so something changed once I did.

Speaking of BP meds, besides beta blockers I did have a major problem with a diuretic medication. The diuretic worked like a champ in reducing my BP by 10 points overnight. I had to pee a lot more as that's how diuretics works. However I started having gout attacks left and right after not having one for years. I'd successfully controlled my gout problem through diet modifications. However getting dehydrated is one way to bring on a gout attack. So I had to go off of the diuretic. If you are on a diuretic and that big toe (or some other joint) starts hurting, talk to you doctor.

Good luck. Take it slow and build back up. I bet they have to rein you back as you sound like you are chomping on the bit. As my cardiologist has said more than once "I wish all my patients were like you." Hopefully you doctor will be saying the same to you.

Ah, stopping the stress test, I remember it well (ahem, I think we've seen enough here, sir... later my very young GP, who I think still attends frat parties, looked at the readout and said, "Oh yeah, you're f***ed") . I think you'll enjoy the rehab - it's 90% exercise and 10% lectures on obvious stuff like eating right. You can also ask questions about your drugs, so you can get other points of view.

My angiogram (to which I cycled - thank you angiogenesis) showed 4 arteries @ 100/100/90/70 blocked so I was able to skip the stents and go right to the bypass. After the surgery, I found the cardio rehab beneficial for one reason - you get to exercise under supervision, which makes you feel much safer. For the first few sessions, they monitor you telemetrically with the electrodes on your chest. My goal was to find the level at which I could exercise safely, using a (supplied) HR monitor and typical gym machines like rowers and bikes with power readouts. I went a couple of times a week before work for four months, which is probably more than I needed - after the first month I was basically paying 100 bucks a month to do something I could do on my own.

Take 'er slow - it's been 7 years now (I'm 67) and I'm still seeing performance and strength gains from exercise.

You've gotten great advice hear. Cardiac rehab is a great first step. You get the monitoring and education so that you work up slowly and at the end you know what you can do. I am very lucky. My cardiologist is a marathoner and my cardiac rehab exercise specialist is a cyclist. They encourage me to do all that I can and still stay safe and they are very specific about what safe means.
My doc won't give me a stress test. He says the rate of false positives for post MI patients is too high to make it useful without some symptoms during exercise.
Yes, you do get better after rehab. Several of my meds have been cut or stopped. We had a 45 year old come in after a heart attack during a bike race. He recovered and went back to racing. Best of luck with the rehab!

That's tough. I had a heart attack at 53, while riding the bike. I was lucky in that my stress echos all came back good, and I am riding strong.

It's really up to you. For me, I would not want to sit on my azz and start getting fatter, and sicker. They probably gave you nitro-stat. Get multiple bottles. stash one in your car, seat bag, back back if you wear on, and even your wife's purse.

I had a second event five years later. It came out of the blue. One of the stents had re occluded, and the onset was so sudden they figured that I had a "ruptured plaque" that blew a clot into the stent. It was bad, but I am back on the bike again.

I figure I can get hit by a spoiled teenager texting while driving daddy's Beemer, have "the big one", or die a low miserable death sitting on a couch.

I am not a religious person, so don't fear hell. I've lived past half a century, and have a bright grand kid who will do good in life. I have no regrets, and chose to go out living life. At the same time I am not crazy, and am not looking to die. The choice is yours.

Were you hypertensive before the heart attack? How much heart muscle damage based on the echocardiogram? They usually tell you your ejection fraction (EF) which tells you how strong or weak your heart muscles are. Normal is 55-70%. Below 35% prognosis is worse. Are you diabetic? I can imagine you are on aspirin, platelet inhibitor (plavix, brilinta or effient), a statin, beta blocker and likely an ACE inhibitor or ARB for your high BP. I agree you need cardiac rehab to see how much you could do. Not sure why they stented the 70% artery which was blocked. Usually they will test it non invasively if it is causing problems. Good luck on your recovery. With time, proper diet, good BP control- you can get back to your active lifestyle.

Sorry to hear about your heart attack but glad to hear you survived. For close to a year I was having heart pains almost daily but ignoring them. Last September I had a major heart attack at my island home. It took about 4 hours to get me off the island and to a major hospital. In the ambulance, I watched the monitors as I flat-lined multiple times (no pulse, no blood pressure, total respiratory failure). After emergency treatment, I was in the ICU for 10 days and in the hospital for a total of 22 days.

After another month of home health care, I started a cardio rehab class. It was the best thing in the world for me at the time. I started out fearful that any exercise at all would bring on another attack. In the cardio class, everyone wore a heart rate monitor and they continually checked blood pressure. I started out at the lowest level of the easiest machine for the shortest time.

As I gained strength and confidence, the cardio nurses allowed me to work harder and harder. I went to a total of 36 classes and was taught many things about heart care. They told me to "move, or die" so I bought a bicycle and have been riding ever since. I wear a Cateye heart rate monitor and my beta-blockers keep my heart rate way down, but I can ride up to 25 miles before seat pain stops my ride.

I hope you have a similar recovery or better! Beware of the depression that might follow. I got it and battle daily to keep moving.

Best of luck.

Had a heart attack in 2010 - the doc said it would have been a lot worse had I not been in good shape (riding 100 + miles a week)! Figure it was caused by stress since I'm my wife's full time caregiver. Any way, once cleared for cardio rehab I went at it pretty good (3 times a week plus walking as often as possible). Started adding strength training to regular cardio (treadmill, crosstrainer, row, etc.). Also, got back cycling when cleared for it.
Just went for my annual cardiologist appointment and my EKG was "textbook", blood work normal; he said to keep doing what I'm doing. I hit the gym two to three times a week and ride my bike as often as I can (15 - 20 miles per ride), mostly greenway - hey, I'm 71 and don't need to be "dicing" with cars. Anyhow, I'm in better shape than I was when I was 50, feel great and was able to reduce the medications and/or dosages considerably.

Can't add anything to whats been said except tell you I had a heart attack in 2002 at the age of 47.I kind of expected it as my father died at 48 and all his brothers except one, the same.I also smoked and drank heavily though my saving grace was I worked very physically.So I survived.Since ,of course, I quit drinking and smoking and started biking which I do extensively though less than I'd hace liked this year.My stress tests are glowing as as is my blood pressure and I feel pretty healthy.I take statins,beta blockers aspirin and fish oil which is not a fad.My weight is too high and my diet is bad so there is much room for improvement above that which I've already made.About 3 years ago I had 2 more stents inserted for another narrowing artery they discerned.So keep being monitored and do the right things and you can ride and live till 100!

I am 59 and found this discussion kind of scary. Did most of you exercise at younger ages...like 20's 30's and 40's? We're you overweight? Smokers? When you bike now would you say you pushed at 75 percent of maximun or better?

Mike A.

I find it a bit scary too. I'll be 51 in a couple of weeks. Had a full physical earlier this year and all looks great....doc even asked if I was a vegetarian (not by a country mile LOL). I still gorge on bratwurst, beer, and bacon double cheeseburgers....bp is 118/71 and cholesterol and blood sugar are excellent. But for how much longer?? See, the bike riding started 6 months ago because I was having some symptoms that were not good, but nothing was found to be medically wrong....doc diagnosed it as stress. After logging in about 700 miles this summer, I feel great again, so I guess he was right.

I have the same questions for those of you that had an M.I......Anything precipitate the event say a day or two before? Were you under any type of abnormal stress, just as job etc? That's my concern.....type A overachiever personality with a high stress job. I ride about 75 miles a week, work in my yard, and walk a lot on my job....I'm just concerned that the stress is going to catch up to me at some point.

Excellent thread....it's good to hear from folks who've been there.

Having a positive attitude is a big plus and the group at my cardio rehab were so positive and supportive as they helped me through a difficult recovery and set me on a path I'm still following. My EF was twenty in 2010. New docs would ask if I needed a wheelchair when my wife made me an appointment. Now I'm riding and working out at the gym. You wouldn't know I was ever as sick as I was. Getting better is possible.

I would go back and ask more questions and get a second opinion if needed so you are very clear on exactly what is happening and what is preventing you from being able to exercise. Nobody elses experience matters. Perhaps you need another stent. Perhaps ablation. Maybe nothing can be done but the answer isn't in this forum. If your doc gives you anything but a clearly understandable explanation of why you can't exercise hard and why nothing can be done about it, get that second opinion. I've had two heart attacks and am rockin 5 stents and I'm cleared to go full tilt boogey and race as hard as I can although I'm on beta blockers so the odds of getting a contract with Sky remain slim. But like I said, my experience means nothing to you other than in -some- circumstances, heart attacks do not have to be an end to hard riding. Go pin that dr down on what's going on.

Thanks everyone for sharing your experiences and your encouraging words.

To answer some questions, I was under treatment for high blood pressure and lipids for probably the last 20-25 years. They were under control with medication. Also I was at a good weight(150). I started regular aerobic exercise about 10 years ago with jogging and, later, cycling. I was feeling very fit - no chest pain, no shortness of breath. However, I was a smoker up to about the age of 40 and probably not that active.

The heart attack was totally unexpected. I was out for a planned 30 mile ride, something I did several times a month. At first I though maybe I was pushing a little too hard getting chest pains and breathless and all, but I had all of the classic symptoms.

I don't yet know the specifics of the damage. I guess I was hoping I'd be closer to where I was before the attack. The stress test was a bit of a shocker.

Although I feel pretty good physically, I do have a lot of anxiety. I'm no stranger to that but it is there and something I need to deal with to feel better.

Again, thank you all for your comments.

Glad that you are doing better, don't push the return to your pre-attack level of fitness hard, anxiety about that, coupled with the worry in the back of your mind about another MI can weigh heavy on your heart (and not in the metaphorical, mushy stuff way.) I had to find a means of shedding the anxiety from a heap of major surgeries between 2000 and 2010, developing chronic kidney disease and now Parkinson's Disease. Stress kills, big time, anxiety is stress being manufactured, I hope you can find a means of releasing yourself from the stress so you can continue to recover well and get complete rehabilitation of your cardiac system.

Many of our members, as shown by the number of replies so far here, have experience with heart attacks and the recovery from them. I am very fortunate given my family history of heart disease death that I haven't had anything, my one cathertization was very good, the cardiologist said I had sewer mains for coronary arteries (as a civil engineer I wasn't quite sure how to take that one:rolleyes:) Getting torn away from your old levels of activity has gotten you down mentally, and that is wearing on you as much as over training can be. There have been recent threads here about cyclist getting sicker, having cramps in their legs and other maladies from their exercise level being cut or stopped, you seem to be in that category. I can personally attest to that one, when I get slowed or stopped I can feel the PD getting worse for a bit.

Use your friends, and you have a bunch of new friends here, now, and your family to buck yourself up and let things just go when you feel the worries getting out of hand. I hope you will keep us posted on how you are doing and your progress, best of luck with everything, you are added to my prayer board list.

Bill

I think it will depend on the amount of damage done to your hear during your heart attack.
I was able to eventually return to an active lifestyle with 65% capacity. Let me say this though a bike forum isn't a good place to be seeking medical advice. Talk to the people who saved your life your doctors they have a better idea of your condition.

Bike forums aren't a good place to get medical advice but it's a great place to get inspiration from people who've had similar problems and have carried on. Depression and anxiety is a big problem for men who've had recent heart attacks. The OP should know that a lot of guys have been in the same boat and he can use their stories as a metaphorical crutch to lean on.

the reason I wanted to find out answers to the questions I asked above is because I am almost 60 and I have been exercising every day or every other day for almost the last 40 years. I push myself extremely hard when I ride...usually about an hour ride. I was a runner for 25 of those years. Has anyone worked out with this kind of intensity? My pulse is usually about 150 beats per minute 5 seconds after I am done and in one minute usually abut 120 beats per minute... I have heard theories from folks pro and con but I am looking for someone else who has followed this type of exercising and developed heart problems... I sometimes think this is not a good idea but I feel great...I never smoked or drank and my bmi
is normal...

I had my heart attack on April 20, 2013 and got back on my bike June 9th. I also led a cave trip (my other passion) on June 20th.

I went to cardiac rehab for 18 sessions (3 x week). All through the rehab, they told me over and over to "listen to your body" and do what you feel comfortable doing. So that's what I did...if I felt comfortable and able to do something, I did. People kept telling me that I should take it easy, but I refused.

I felt myself get stronger day by day, and now, 16 months later, I feel better than ever. My cardiologist is happier than a pig in you know what. :)

I am glad you are doing well. Interesting. I have been hearing people telling me to slow down for at least 20 years now. I do not share my exercise routine with people who don't work out...even most who do work out...I guess I have been doing just like you...listening to my body...once back in 1983 I felt heart pain for a few seconds and stopped running immediately...scared me. I absolutely don't feel I have any less energy than when I was 20 years old... I just see so many people around my age who have very little energy and are ready to retire...I always wonder in the back of my mind when will I slow down and what will cause it?

I wasn't seeking medical advice.

It's inspiring to know that so many of you have struggled, overcome and are thriving after very difficult experiences and are dealing with ongoing problems in such positive ways.

Thanks again for all of your comments and words of encouragement.

Had mine at age 56, two years ago this past June, 3 stents in my RCA.

i had lost 55 pounds, rode 30 plus miles was my usual route, gym 3 times a week. It was as I was just finishing my workout, I was sweating profusely and out of breath, figured I would sit in my truck with the air on and cool down and catch my breath. Neither happened, was sweating more as time went by. By thus time my brain is in the oh crap mode, thinking I can't be having a heart attack. Short time later, pressure in my left shoulder followed by my left arm tingling. Shut truck off, went back in gym and asked them to call 911. I was wheeled out of the cardiac cath lab just under an hour and a half after symptoms started, very little damage to my heart. Spent the weekend in ICU, then home.

Met with the cardio the next week, did not have to do cardio rehab, just keep doing what I was doing. 1 year later, off half the meds, and reduced dose for another. Walking a couple of days after the attack, albeit very slowly and short distance. Back on my bike within a month with the restriction of 5 miles max, heart rate below 110 (I ride with a HRM). About 6 months later, HR 130 max and basically no mileage restriction. Had a stress test a year after the attack, passed with flying colors. My second year, no stress test needed. About the only thing now is a little light headed when I get up too fast, and do not have the energy I had before the attack. Gained back a little weight, but maintaining it currently and working on dropping it, tough when I am on the road a lot. Blood work is normal, as it was when I had the attack.

I refused to let this get me depressed, just happy I recognized what was happening and that I am still around.