Paweł ChalacisPaweł Chalacis

This post was in my backlog for a long time, but there was always something more important to do. Meanwhile I’ve moved around the world and raised my fitness to the point it has never been before, my blood results were never better and my VO2Max sits around 60 (which is great considering almost 10 years of smoking). But, couple of years ago I got scared a little and had my heart tested.

When I signed up for the gym back in 2012 I was not living the healthiest life for sure. Yes, there were few ideas sparking in my mind and I heard something about this thing called Ironman that crazy people do, but I didn’t expect I will run a marathon, let alone pay $800 to do an Ironman race! In November 2011 I moved to London and started regular 9 to 5 job after spending 2 years in front of crappy life: sitting 16 hours per day in front of computer, smoking 2 packs of cigarettes per day, drinking 2 litres of Coke and couple of beers per day (and that’s just a tip of the pile of crap called “different story” ;)).

Anyway, because of ticket prices in London (£150 per month from where I lived) I decided to cycle to work as much as possible. Which was about 2 times per week, I was so unfit. Then I signed for a gym as a natural progression, when cycling became easy. At that time I would eat health-ish, still drink a lot of diet Coke and considerable amounts of alcohol (few drinks couple of times per week). My respiratory system was still recovering from years of smoking various things. My weight was around 85 kilograms and I couldn’t run more than 3 kilometers.

After I signed up for the gym (37 degrees, best gym I’ve ever been to!), one of PT asked me for few details, my goals and previous fitness experiences. Then he took my blood pressure, which showed whopping 145 systolic by 95 diastolic. That was not what I was expecting, since I considered myself quite healthy at that time.

So I followed up with a GP, who referred me to have basic ECG scan. Here it is.

At that point I got really scared. “Abnormal ECG” doesn’t sound too good, does it? I’ve done lots of research and changed my diet to see if I can make it better on my own, without any medications. At the same time I’ve been asking my GP multiple times for cardiologic follow up. It took 6 months to get the appointment. During that 6 months I stopped drinking heavy alcohols (and limited beer / wine to few per month), removed coke and other fizzy drinks completely and even switched to decaffeinated coffee for couple of months (and then switched back to regular, spreaded across the day, without “extra shot” orders) while getting fitter and losing weight. I started observing something that I can best describe as skipped beats, when it feels that my heart stops for a second or two.

Fast forward to January 2013 when I finally got tested (once again - it took 6 months in UK to be referred to the specialist after receiving “abnormal ECG” result). Now that one was quite comprehensive. I got another ECG scan blood pressure check (110/70!), Echocardiogram and Holter monitor, a portable heart monitoring device that you get attached to your body for 24 hours. All results were within good or great values. There were “episodes of bradycardia”, which is heart rate too slow to be considered normal, with lowest HR at 36 bpm during night. I took that as a sign of getting fit. Yet, the test was done after one year of training almost every day, after I signed up for my first triathlon and after I composed my list.

I’m sure that the problems I had couple of months before were caused by caffeine / alcohol and were fixed after week or two. All the rest (irregular heartbeat, possible ventricular hypertrophy, bradycardia), after eliminating any diseases, are very consistent with Athletic heart syndrome.

According to wikipedia, Athletic heart syndrome, also known as athlete’s heart, is a non-pathological condition in which human heart is enlarged and resting heart rate is lower than normal. Medicide define “normal” heart rate to be between 60 and 100 beats per minute. Anything slower than 60 is considered bradycardia. But, while it is a problem when seen on untrained person, it is a common adaptation to chronic exercise.

Heart is a muscle, and as any other muscle - it can be trained. In endurance athletes left ventricle capacity can increase by 50% in volume and it’s walls can increase their thickness by 20%. Heart can pump more blood more effectively, hence it doesn’t have to beat so fast. What would be pathological is now considered a positive response. I have been told that my heartbeat can actually be observed when I lay down and try to relax. I can only imagine how it works for the pro athletes (with VO2Max in 70 - 80 range). Crazy, right?

Yet, while making you fit, heavy training can cause problems with your heart by exposing existing conditions. One of most dangerous one is called Sudden Cardiac Death. Sounds serious and actually is serious. Basically, it’s a sudden arrhythmia that causes the heart to stop pumping blood. According to statistics, SCD is much common during and shortly after exercise, with recent studies showing risk to be 1 per 370,000 half marathon participants, 1 per 101,000 marathon participants and 1 per 75,000 triathlon participants. Around 30% athlete victims of cardiac arrest during marathon or half marathon events were successfully resuscitated.

One thing to point out here - Athlete’s heart is not the cause of sudden cardiac death, which mainly occurs due to hypertrophic cardiomyopathy (enlargement and thickening of heart muscle without a reason). That’s why it’s important to distinguish between athlete’s heart and hypertrophic cardiomyopathy.

Disclaimer: I’m not a doctor. If you have any doubts or health problems - consult your GP!

If you want to know more, check the sources I’ve used to write this post:
http://www.endurancecorner.com/Larry_Creswell/9_heart_facts
http://www.athletesheart.org/
http://en.wikipedia.org/wiki/Athletic_heart_syndrome
http://en.wikipedia.org/wiki/Hypertrophic_cardiomyopathy