Marathon running/heart damage...

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Tim Carmichael

148 posts since
Oct 5, 2007

60. Mar 18, 2007 8:20 AM

in response to: dtoce

Thanks, Dale. As of a couple years ago, my cholesterol was great. As for family history, wellll.... Having found out a couple years ago that I was adopted kinda throws the family history thing out the window.

I think I'll go see the cardiologist. Thanks. Tim

dtoce

383 posts since
Nov 10, 2003

61. Dec 22, 2007 7:53 PM

in response to: dtoce

quote:<HR>Originally posted by Jim24315:
How about pulse pressure as a risk factor? Pulse pressure is the difference between systolic and diastolic numbers. For example with a reading of 120/80 the pulse pressure is 40. I've read that pulse pressure is a "powerful indicator" of coronary disease. 40 is supposed to be ideal, low 50's and below is ok, and 60 or above is high risk.

This means that 120/80 is better than 120/70, or 122/82 is better than 115/65. A reading of 130/70 would be entering the danger zone.

Any comments on this?

<HR>

Pulse pressure per se isn't a risk factor, but it is associated with 2 types of heart disease. First, systolic hypertension. As one ages, the blood vessels sometimes get a bit thickened and 'stiff' leading to high blood pressure. This is associated with stroke at all ages and increases with age and with SBP.

Second, a high pulse pressure is associated with a specific kind of valve disease called aortic regurtigation. There are four heart valves and 3 normally leak a little bit and that's no big deal. None should stick or become 'stenotic'. The aortic valve is very important and shouldn't leak at all. When it does and becomes significant, then the heart pumps a higher volume of blood (a regurgitant volume) and it dilates to accomodate. Another compensatory mechanism that occurs is that the pulse pressure goes up. So a higher than normal pulse pressure should prompt a good doc to listen for the murmur of aortic regurgitation...

Low diastolic blood pressure numbers aren't necessarily bad at all unless something else is going on. For instance, if you get a bad systemic infection, then the body compensates by increasing the cardiac output and the infection causes vasodilation by the toxins in the bacteria. This state causes low blood pressures with low diastolic blood pressures. Often the numbers are like 90/30 or 90/palp when someone is in septic shock and has a very low blood pressure.

This is different than the patient presenting to the office with a BP of 130/70. That is a number that I strive for.

http://This message has been edited by dtoce (edited Mar-18-2007).

Jim24315

1,988 posts since
Dec 14, 2007

62. Dec 22, 2007 7:53 PM

in response to: dtoce

quote:<HR>Originally posted by dtoce:

...Low diastolic blood pressure numbers aren't necessarily bad at all unless something else is going on. For instance, if you get a bad systemic infection, then the body compensates by increasing the cardiac output and the infection causes vasodilation by the toxins in the bacteria. This state causes low blood pressures with low diastolic blood pressures. Often the numbers are like 90/30 or 90/palp when someone is in septic shock and has a very low blood pressure.

This is different than the patient presenting to the office with a BP of 130/70. That is a number that I strive for.

http://This message has been edited by dtoce (edited Mar-18-2007).<HR>

So, you are saying that 130/70 is good. Is that right? And to further clarify, would you say 120/80 is better than 120/70, or does it matter?

Another big thank you from me, Dale. Your input has been greatly appreciated.

tomwhite

2,001 posts since
Dec 14, 2007

63. Mar 18, 2007 1:15 PM

in response to: dtoce

...............while fully appreciating tet's comment,
I am trying not to reply so as not to encourage him.......

jjwaverly42

337 posts since
Dec 14, 2007

64. Mar 18, 2007 1:31 PM

in response to: dtoce

None of this matters. Run!
You'll die when it's time.
No sooner, no later.
Maybe you're exit is supposed
to be in a marathon. Beats suffering with tubes down your throat.
Have fun.

--Jimmy

P.S. I'm only scared of death when I think about it. And that's only because of the possibility of complete annihilation of the psychological self. So, I don't think about it.

dg9005

1,325 posts since
Dec 14, 2007

65. Mar 18, 2007 3:15 PM

in response to: dtoce

Dr. Dale,

Another thanks from me for starting this thread, even more so for your patient answers.

I've read through the posts, but a little quickly, but have only read the first article so far. I hope my question isn't redundant or out of place here.

Is there a set of tests, including specific types of blood work, that you would consider a comprehensive workup? I'm asking because I've been having what look like cardiovascular related symptoms since the beginning of January, & am going to finally be tested in April. I do like my doctor, but I've only seen him twice so there's no history there. I've described to him what's been going on, but he tends to think it's not 'heart' because he says I'm not the type. I hope he's right! but am afraid he might not be. My concern is that he will order a few tests, & if they don't show anything, will give me the 'all clear' & recommend stress reduction techniques. I agree with doing that, but know of several cases where prelimary tests didn't catch the problem. I want to run as much as I can get away with & don't want to worry about it. I'd like to know what to ask for if it comes to that point.

Not that you need to take the time to read this, but my symptoms are described toward the bottom of the page in this thread. http://www.coolrunning.com/forums/Forum13/HTML/008907.shtml[/URL" target="_blank">

I've gotten excellent advice from this site as far as training properly, & am trying to follow it.
Mike, I loved your comment.."How many RW would sell if the cover said 5 Years to Your Best Marathon...we need instant gratification....but I digress..."..

Thanks again.

------------------
debbie

duckgeek086

83 posts since
May 17, 2004

66. Mar 18, 2007 5:34 PM

in response to: dtoce

Replying to Econo's question about football games...

I work in the Stadium Ops center at Autzen on game days as a dispatcher, alongside red cross, police, fire, campus safety, etc. We plan on 1 "medical event" (heart attack, stroke, diabetic reaction, etc.) for every 10,000 patrons, or in our case 6 events for 62K at Oregon.

The most that I've seen (not including passed out drunks) is 10 at one event. This was on a hot, sunny day with a late afternoon start. The EMTs were very busy that day.

nighthawk42

119 posts since
Nov 4, 2005

67. Mar 18, 2007 5:59 PM

in response to: dtoce

Thanks Dale for answering so many questions!!!!!! Greta post

Mike

dtoce

383 posts since
Nov 10, 2003

68. Dec 22, 2007 7:53 PM

in response to: dtoce

quote:<HR>Originally posted by dg9:

Is there a set of tests, including specific types of blood work, that you would consider a comprehensive workup?
Thanks again.

<HR>

Debbie,
Sorry I missed this comment...Unfortunately there is no 'comprehensive workup'. Everything is and should be individualized. That said, we are all associated with certain numbers which give us some information about our own heart related risk. These numbers include: your BP, your lipid numbers, your weight, your blood sugar. I tell all of my patients that they need to weigh risks and benefits of various activities and understand that dieting and exercising is an important adjunct to their daily activities...if they want to be active for longer.

Some people should have additional testing for heart risk. This would include people who have lots of risk factors for CAD-as I've stated previously. I think that we all should know the numbers I described and what our 'ideal' numbers should be. If an EKG is done and is abnormal, sometimes a stress test offers some idea if there is underlying CAD and ischemia or clogging of the arteries. Not everyone needs a stress test, though. Certainly a stress test is better than a resting EKG if you are comparing the ability of the test to predict cardiac risk, and therefore a stress test is more 'comprehensive' than the EKG. It's just that an expert should decide if a patient should have one or not...

Hope that helps!
Good luck.

http://This message has been edited by dtoce (edited Mar-20-2007).

dtoce

383 posts since
Nov 10, 2003

69. Mar 20, 2007 4:23 PM

in response to: dtoce

quote:<HR>Originally posted by Jim24315:
So, you are saying that 130/70 is good. Is that right? And to further clarify, would you say 120/80 is better than 120/70, or does it matter?

<HR>

Jim,
To be honest, it probably doesn't matter at all. I would consider both of them normal and therefore, 'good'.

dg9005

1,325 posts since
Dec 14, 2007

70. Mar 20, 2007 6:15 PM

in response to: dtoce

Dale,

That's ok! You've already done so much here. This helps me understand the mindset of my doctor. I won't go in with any preconceived ideas, (less, anyway) & that should make the whole process easier.

I've had people recommend seeing a cardiologist who is a runner. Do you think that would make enough difference to ask my PCP about that? I wonder about it especially because the symptoms began just after 4 months of newbie version overtraining. I have very few risk factors, but lots of symptoms.

quote:Hope that helps! Good luck.

It really does. Thank you. I hope you heal quickly, & good luck with Mt. Washington!

------------------
debbie

rbbmoose

324 posts since
Oct 12, 2007

71. Mar 21, 2007 7:32 AM

in response to: dtoce

quote:<HR>Originally posted by jjwaverly42:
None of this matters. Run!
You'll die when it's time.
No sooner, no later.
Maybe you're exit is supposed
to be in a marathon. Beats suffering with tubes down your throat.
Have fun.

--Jimmy

P.S. I'm only scared of death when I think about it. And that's only because of the possibility of complete annihilation of the psychological self. So, I don't think about it.

<HR>

Well put Jimmy - I'm not scared of death, but dying sick scares the **** out of me.

Ray

dtoce

383 posts since
Nov 10, 2003

72. Mar 21, 2007 8:16 AM

in response to: dtoce

quote:<HR>Originally posted by jjwaverly42:
None of this matters. Run!
You'll die when it's time.
No sooner, no later.
Maybe you're exit is supposed
to be in a marathon. Beats suffering with tubes down your throat.
Have fun.

--Jimmy
<HR>

I suppose if you are a fatalist, then there is little I can say to influence anyone. However, as a practitioner of medicine, I truly believe I've impacted hundreds, if not thousand(s), of lives over my career.

People make choices when it comes to doing simple things like exercising or not. Maintaining a healthy weight or not. Taking medicines that are reccomended or not. These may be informed decisions or not.

Running is fun. Running is healthy. Racing can be a tiny bit dangerous-especially for those who do not train properly, especially longer distance races. But in general running is also fun, invigorating, challenging...and many other descriptive words. This is one of the reasons we are all here on this running board.
-----------------------------------------------------------------------------------

I'm not proposing that anyone is radically changing their destiny, but I'm not ruling it out either. No one wants to suffer or see anyone else suffer. I am an organ donor and my wife knows my advanced directives so I will never be stuck on a ventilator with 'tubes down my throat'. I have lived and experienced these nightmares with some of my patient's families already. I have 'saved' people only to find that they will never wake up and have then let them die with dignity, but they were given the best chance at survival before 'pulling the plug'.

Perhaps you should make your wishes known to your loved ones if you want to make sure that sort of ending doesn't occur...and consider influencing your own destiny by taking cardiac risk factors seriously.

that said, I hope you, Ray and I all live to race for many more years before checking out,...

rbbmoose

324 posts since
Oct 12, 2007

73. Mar 21, 2007 8:45 AM

in response to: dtoce

A very good point Dale - I DO have a living will - having just gone through this whole thing with my mom (who also had a living will) I have a real appreciation for thee value of documenting your wishes.

I also have a real appreciation for the role that doctors like you can play in assisting with carrying out these wishes in a sensitive and dignified manner. It makes a huge difference. Thanks for taking the time with this thread.

Ray

DaveVause

690 posts since
Jul 9, 2007

74. Mar 21, 2007 12:35 PM

in response to: dtoce

What frustrated me about this study was that it correlated total weekly mileage to the incidence of abnormalities, but not how long the long runs in training were. The typical 35 mpw runner doesn't do 20 mile long runs in preparation for a marathon. But, it could be argued that to be prepared physically, you need several long runs in the 18-22 mile range to be in shape.

I have to wonder if the lowered rate of abnormalities is not because the weekly mileage is >45 mpw, but because of the greater number of longer long runs which are typically run by people doing higher mileage.

------------------
You are what you repeatedly do.

www.vause.name[/URL" target="_blank">

Dave Vause
08 MC Historic Half
07 Frederick Marathon
05, 06 MCM
blog: //community.active.com/blogs/DaveVause
personal web site: www.vause.name

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