Friday, February 17, 2012

Running with My Special Heart

Around the year 2000 I was kicked in the back of my calf by another basketball player. He was one of the dirtiest basketball players I have ever played with and I believe his kick was intentional. The immediate pain was severe and I was initially worried he had broken my leg. I limped off the court and went home to apply RICE - rest, ice, compression and elevation.

Over the days to come I was able to bear weight on my injured leg, but the pain was severe and very localized. I could not find a position of comfort, the pain kept me awake at night, and seemed unresponsive to ice or NSAIDS. After several days of no relief I went to see the doctor.

An x-ray concluded I did not have a fracture but an ultrasound found a very small blood clot deep in my calf. At the time the doctor (or PA ... I don't recall) suggested I continue with RICE.

A few days later and antsy for exercise I decided to take an easy jog. A few steps down the gravel road we lived on and I was so winded I could barely stand upright. I caught my breath and tried to run. Again so winded I couldn't continue. I also began to experience chest pain. Most significantly was the leg pain was gone.

I limped home and rested. The next morning, still having chest pain, I went to urgent care. At the time I was either not yet an EMT or in EMT class, again this was more than 10 years ago. A male in his late 20s complaining of chest pain didn't cause any alarm with the triage nurse.

After a long wait in the holding area I was finally seen. One set of questions led to more questions led to more assessment. Before I knew it I was having a chest x-ray, ultrasounds, 12 lead ECG, cardiac ultrasound, and being scheduled for a stress test. The cardiologist decided I wasn't in any immediate danger. In passing he added "has your valve defect ever given you any problems?"

Ummmm ... my valve defect?

"Someday you will have to get that replaced," he casually added.

"My what," I asked?

He went on to explain that my aortic valve should be a tricuspid but it is a bicuspid. This is quite common that instead of having three flaps the valve only has two flaps. Over time, usually in old age, this becomes a problem and valve replacement is required. A valve can be replaced with either a mechanical valve or a pig valve.

A few days later I did a cardiac stress test and rocked it. The doctor decided I was out of the woods, fit, strong, and healthy.

Ever since I have been interested in learning more about the impact of endurance sports on the heart. Stories of marathon runners experiencing sudden cardiac arrest in a marathon receive lots of publicity but the actual risk is very low. There is also ongoing research about the stress marathon running causes on the heart. This article, Short-Term and Long-Term Injury to the Heart with Exercise, presents some new findings.

My wife, partly because it is her nature, worries about me when I go out for long training runs or race a marathon. I worry to, but about more likely stuff (I will trip, I will run out of water, I will get hit by a distracted driver, I will get chased and bitten by a dog).

When it is all said and done though if my destiny is sudden cardiac arrest I would much rather have it happen at mile 20 instead of hour 20 of a Jersey Shore TV show marathon. Life is full of risk. I still believe the benefits of regular exercise and eating well far outweigh the risks of heart injury from exercise.

What do you think? Does the research about exercise and cardiac injury cause you pause or concern? Are you also running with a bicuspid valve? Or are you running with a replacement valve? Share your views and experiences in the comments section.

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