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more re Ed Burke and heart attack prevention...(7 posts)

more re Ed Burke and heart attack prevention...trekkie1
Nov 21, 2002 7:18 AM
From the Road Bike Rider newsletter

Last week, we were among 400 people at the memorial
service for Ed Burke.

Many were his friends from the University of Colorado
at Colorado Springs, where Ed was a professor of biology.
Others represented cycling, where Ed was a world leader
in physiology and technology.

The service was moving but not tearfully melancholy.
After all, we were there to celebrate a remarkable life. Ed
Burke was a man of good nature and a positive outlook.
His personality brightened everyone he met.

Perhaps the most wrenching part for cyclists was seeing
Ed's red-white-and-blue GT road bike. It stood lonely at the
front of the room with his helmet and shoes, water bottle in
place and the chain still in low gear. It was on a climb
where Ed suffered his fatal heart attack on Nov. 7 at age 53.

As we chatted with other riders after the service, we
learned more about events leading to Ed's death.

How could a relatively young and apparently fit person
suddenly collapse and die during a ride? Should the rest of
us in his age range be worried, too? We think that Ed, who
wrote extensively about training and fitness, would want you
to have some answers.

Here's what we know:

--- Ed was physically inactive for at least 20 years after
racing in college.

--- In 1997 he decided to get back on the bike. Overweight
and nearing age 50, he admitted concern about his
family's history of heart disease and his own high cholesterol
and blood pressure.

--- He worked back into shape carefully. He routinely refused
to do rides that demanded more than he was ready for.

--- He became an enthusiastic long-distance cyclist,
completing Alaska's Iditabike and the Leadville 100-mile
mountain bike race, among other endurance events. On the road,
he favored tough challenges like Colorado's Triple Bypass.

--- In recent months, he admitted to poor performance on the
bike. In October, he told us he planned to stop riding extreme
events and scale back to "sane centuries."

--- On a ride two weeks before he died, Ed had to stop
several times because he felt so bad with indigestion. He
couldn't figure out what he'd eaten to cause it.

Inexplicable indigestion may be a precursor of heart attack.
We're sure Ed knew this, both academically and because a
friend, ex-pro Hugh Walton, had experienced the same symptom
before his own near-fatal coronary. In fact, Hugh told us
that he and Ed had a long talk about heart problems while
riding together last June.

But apparently Ed didn't heed his own warning signs. In
hindsight, it seems clear that his heart was beginning to
fail. The lesson for the rest of us is obvious: Be vigilant!

o^o o^o o^o o^o o^o o^o o^o o^o o^o o^o

It's estimated that 59 million Americans are living with
some form of cardiovascular disease.

Many people who die from a heart attack have symptoms the
week before the fatal incident. These include chest pain,
increased fatigue, dizziness, ankle swelling and indigestion
or heartburn.

Seek help immediately if you experience any of the following
symptoms of a possible heart attack:

--- Pain or pressure (squeezing sensation) in the middle of
the chest that lasts more than a few moments.

--- Pain that radiates down the arms or into the neck or jaw.

--- Chest discomfort accompanied by shortness of breath,
lightheadedness, sweating, nausea or fainting.

o^o o^o o^o o^o o^o o^o o^o o^o o^o o^o

It's much smarter, of course, not to wait till your heart is
in trouble. To take the initiative on this issue:

--- Find out all you can about your family heart history.

--- Avoid the risk factors that produce coronary artery disease.
These include smoking, hypertension (blood pressure
should be under 140/90), and cholesterol (total should be
under 200 with HDL above 35, LDL under
Nov 21, 2002 7:19 AM
...under 100 and triglycerides under 200).

--- Get a CRP test. Inflammation, and its role in heart disease,
is a promising new research area. Ask your physician about
testing for c-reative protein (CRP), a substance the liver makes
in response to immune system signals that may disclose
inflamed heart arteries.

--- Cut back on saturated fats in your diet and increase
portions of fruit, vegetables and whole grains.

--- Exercise aerobically at least four times per week for
30-60 minutes each time. In other words, ride your bike! But
avoid pushing yourself hard when you're dehydrated, bonking
or cramping.

--- Have an annual physical and take an exercise stress test
as often as your doc recommends. In some facilities, you can
get the test done on a bicycle ergometer and determine your
max heart rate, lactate threshold heart rate and power at LT,
as well as heart function -- all good things to know if you're
interested in performance.

Last Tuesday we talked about stress tests with Andy Pruitt, 52,
who directs the Boulder (CO) Center for Sports Medicine and
wrote Andy Pruitt's Medical Guide for Cyclists.

He told us, "My philosophy has been that anyone over 45 who
exercises intensely should have a 12-lead EKG, max stress test
every other year, and more often if there is any history of
heart disease.

"Personally, I've had three stress tests in the last six years.
Had Ed been on that test schedule, he most likely would still
be with us."
Nov 21, 2002 12:24 PM
Thanks for posting this information.

One of the reasons I persist in riding is the fact that my
father died at age 51 which is manifestly too young.

He was a three pack a day smoker, ate all the wrong foods
(ate nothing but salt pork during the great depression
apparently), and was completely sedentary (i.e. besides
mowing the lawn that was about the extent of his physical

I've managed to avoid the smoking but I do have a love for
fatty foods that I try to keep in moderation. I also am
pretty active with physical exercise of some kind.

Very interesting bits there and too bad he died early.

Same goes for my dad - he didn't have to die. The doctor who was a friend of my parents attended the autopsy and they indicated he'd had perhaps two to three heart attacks before he had the one that killed him but never saw a doctor and when my mother pressed him to go he never would,
even when he was in severe pain.
This might be worth going into in more detail...joekm
Nov 21, 2002 7:52 AM
In the fitness/nutrition center I suppose. I'd certainly like to know more about this anyways. One of the resources I've looked at suggest that your pain tolerance is sufficient to keep you from overdriving your heart. It would appear, based upon this, that may not be correct.

I know that there were three episodes in my life where I was scared that I had overdone it to a dangerous level. Once was when trying to qualify at an elite conditioning level when I was in ROTC (succeded BTW), once during a foot race with my cousin up a large sand dune in northern Indiana called "Mount Baldy", and once doing an extended sprint on my bicycle. All of these were several years ago when I was in my late teens/ early 20's. The run up mount Baldy was the worst. It is partially due to the memory of these episodes that I purchased a heart rate monitor this time around.

One thing the heart rate monitor seems to tell me is that I tend to go too hard when I run on perceived effort alone. I would imagine that there are several of us who would benefit from information on safe cardio training.
When the news first hit...brider
Nov 21, 2002 8:27 AM
I remember a lot of people poo-pooing the connection to Jim Fixx, saying that the cases were totally different. Well, after reading this, it seems the cases are NEARLY IDENTICAL.
More heart rate info...WhoisJohnGalt
Nov 21, 2002 11:51 AM
I'm a 46 year old male rider who has become more aware of my "limitations". Just had a physical with my internist and we discussed heart rate, etc. At 46, my max hr is 174. I routinely set up my heart rate monitor to target the 65 to 85% range. I've noticed that I can easily get my hr up in the 160's and if I really push I can be right at 170-172. So what, right? Doc says to keep it down closer to the 85% mark. (He's also a Sports Medicine guy and a rider as well, only he's about 10 years younger). His point is this: the benefits of pushing yourself past that 85% threshold are quickly offset by the increased risk of heart attack. He used the analogy of a racing engine be pushed to "redline" always, eventually something will break. I will get faster, or at least maintain my overall health, etc, by careful exercise....

I've been riding the trainer and watching Spinervals-just trying to keep up with Troy!
BE VERY CAREFUL HERE!!! (cyclequip
Nov 22, 2002 12:29 AM
I was 37 when I had a serious myocardial infarction. Lucky, cos I was strong and fit, gymming almost daily, active, played golf for a living, just managed to drive myself to emergency clinic at 3am and had staff who got me into ICU and onto the actylase and tridyl in time to save my life. Cardiologist said it was 2 minutes one way or the other (still go cold when I think about it).
But my desire to find answers taught me a lot - one of which is that annual stress ECG's only sometimes help. The indigestion Burke spoke about is common - I was lying in ICU thinking I better get a 2nd opinion cos I thought I had burst a stomach ulcer (after a history of gastroscopy's etc) - but is actually symptomatic of ANGINA.
FOR THE PURPOSES OF THIS FORUM, it's best that cyclists understand the most common precursor - angina - and it's many forms.
The SINGLE MOST COMMON DENOMINATOR IS PAIN ASSOCIATED WITH EXERCISE (Chris Barnard - transplant pioneer). But not exercise pain - it can be a throbbing wrist as you climb your local hill, or a toothache as you play tennis, or indigestion as you climb stairs. But the link betw pain and exercise is constant and recurring. Don't take chances and listen to your body. For most potential victims the damage took place long ago - whether in the genes or lifestyle and can't be reversed (tho some evidence exists that statins can reverse some arterial damage) - the conditions exist and are waiting for critical mass to be reached before triggering one of the many forms of heart attack.