Athlete's Heart

The primary physician at my annual health check gravely informs me that my electrocardiogram shows a T-Wave Inversion, suggesting a possible myocardial ischemia, which is apparently a bad thing.   He recommends that I visit a specialist.

Days, then weeks, go by.  I procrastinate on scheduling the appointment with a cardiologist.  Maybe I am in denial, but I do know that the recent years of exercise do not make me bullet-proof — all the years of stress and lack of sleep and eating breakfast cereal for dinner must have taken a toll.  Some research suggests that excessive endurance training is in fact bad for the heart.  

Then in September I meet one of my seemingly indestructible endurance teammates and am stunned when he tells me that he recently had a stent inserted in his coronary artery.  This guy is a horse — he constantly bounced back nonchalantly from races and workouts that left me shattered.   My attitude has always been to avoid any medical action unless it is clearly necessary — in this case I recall reading that one should not get a stent unless you are actually having a heart attack, doctors often feeling compelled to do something, anything - even if something was likely to lead to worse outcomes.  

More than that, I am certain the specialist will recommend draconian changes — no ironman distance triathlons, no sprinting up hills, no coffee, certainly no heavy cream in my coffee.

Finally I schedule the appointment and in days leading up to appointment I become increasingly morose.  I wake up feeling terribly distressed on the morning of the appointment and trudge to the clinic with a heavy heart (so to speak), the scene from the movie Bohemian Rhapsody where Freddie Mercury receives his terminal diagnosis fills my head.  As I sit waiting for the doctor, I envision asking him to be straight with me and tell me exactly how many days I have left. 

Then the specialist strolls in, takes a cursory glance at the electrocardiogram, looks at me for a moment, and says: “So, can I ask about your lifestyle… for example, like, do you exercise a lot?”  

I pause, wondering what he means by “a lot”

On the Strava Leaderboard for my triathlon club I have logging maybe 6-10 hours of weekly training,  this is only half of the hours of weekly training versus, say, Stan or Jean Marc.  

“Well” I begin to answer, “I only do about 7 hours per week during the base season, but that does not include the core and strength work, and though my recent half ironman time was slow...”  

He abruptly cuts me off as soon as the words “half-ironman” leave my mouth. I was keen to fill him in on the details of my Spartan training exercises, my weekly ratio of volume vs. intensity, and the progression of how many chin-ups I have recently worked up to.

He proceeds to tell me that I likely have what he characterizes as an “athlete’s heart” and I shouldn’t worry.  We do an (expensive) ultra-sound test which seems to confirm his diagnosis.  

I am relieved, but still have one question - the primary physician had also pointed to my high level of bad cholesterol as a warning signal I should take heed of and make big changes in my lifestyle.  I hand the cholesterol test results to the cardiologist and ask if I should be concerned.  

"Naah"  he says dismissively waving off the document like some worthless scrap of garbage, "In your case I wouldn’t really worry about that at all".  

OK, so much for my nascent motivation to embark on an ascetic, vegan diet — I guess I will continue to put full-fat, 40% cream in my coffee and continue to eat hamburgers.

I still don't think I am "bullet-proof" because of all the endurance sports training, but at least there are no immediate, obvious adverse cardiovascular impacts.