chest pain

sspence

Lately, I've been developing upper chest pain when I bike or run. It's odd because it's sporadic and when it happens, I'm not pushing hard and my breathing and heart rate are not that high. I started to feel it last night in spin class but my breathing was under control and my heart rate was 134 (my max is about 185). It is the same sensation I get when my heart rate is close to max. I've been training for triathlons for 5 years and this is something that has come up just recently. I did have a cold 6 months ago and it seemed to show up about that time, but it just hasn't gone away. I'm going to see a doctor soon, but I wanted to know if anyone else had these types of symptoms. I don't have a lot of faith in the doctors in my area. At least not in their diagnosis skills.

jhuskey

Yes, but it was a upper GI problem and nothing to do with my respiratory system.
Your problem could be the same or something entirely different, but I thought I would throw this possibility at you.

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Whenever I can't get excited about riding I just fantasize about someone else's bike.

mikesbytes

Could be an injury. Best to visit a doctor or 2 or 3.

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Training Log

john979

See a doctor ASAP. In 2005, I began noticing some training response patterns I had not previously experienced. I also noticed some minor chest pain that I then attributes to poor posture while on the computer. 2006 saw a real dip in my functional threshold power, but I attributed that to less training and a stressful job. By late 2006, things settled down a bit and I was determined to regain my old form (2004 FTP 320 watts at 75 kg age 44; 2005 FTP 305 watts, age 45; 2006 285 watts age 46).

I purchased a PT300 Pro in December of 2006 and began focused SST and L4 training. I saw excellent progression under a moderate CTL with a controlled ramp. By early March, my FTP was at 290 watts and I was ecstatic. Then bam, at 10-15% drop almost overnight. I assumed a bit of overreaching and backed off a bit, only to slowly recover. It took to June to get back to 290 watts, but I had trimmed 2 kgs off my weight and was reasonably happy. However, once the warm weather set it, I really struggled, then essentially took things easy for the remainder of 2007.

2008 start identical to 2007. However, with this year's power crash I was determined to find the cause. Last week I was diagnosed with mitral valve regurgitation, a leaky heart valve.

Now, all my symptoms that started in 2005 make sense: the chest pain, fatigue, coughing while training (I thought that was exercise induced asthma, excessive urination (it ain't always the prostrate) and extreme thirst while riding (I drink a liter+ per hour).

Without the power meter, it might have taken years more to figure out what was wrong, if I did not drop dead on a ride.

QikSmurf

Look, there is no doubt that chest pain should be treated seriously. Having said that, most upper thorax pain in healthy, fit people is usually muscular or intercartilage related.

In relation the John979, I know of elite athletes that have a leaky heart valve and they compete at the highest level. The type and extent of the leak are the key. You mentioned a mitral valve problem. This means your left atrium is receiving blood back from the left ventricle when the LV contracts.

Out of curiosity, did you have the valve replaced or are you managing the condition? If you are managing the condition, what steps are you taking? I ask becuase one of my athletes has Aortic Valve regurgitation and he is one of the best in our team. I know they aren't the same. His cardiologist said he can excercise as much as he want's and it won't cause any problems or make the issue any worse. They describe his state as asymptomatic. He has a yeary ECG and they monitor his condition. One day they said he may require a valve replacement.

I believe Arnold Shwarzenegger had this very thing his whole life. I know bodybuilding isn't an endurance sport but it is an example of someone with a heart condition that competed at an elite level.

Back OT, if you think your condition is related to your heart (especially if the pain coincides with effort) then your main concern is a blockage of a coronary artery. This won't show up in a ECG. Speak to your doctor today. Often the first sign of a problem is instant death. One of my riding squad dropped dead in 2006 on a training ride on the Gold Coast. He was 26yo with no diagnosed medical condition. Post mortem found no heart irregularities and no toxins n the blood. COD was declared 'unknown'.

Bottom line - get it checked and if you get the all clear, don't worry about it.

john979

I only learned of my problem last week. I don't know much about aortic valve issues, but mitral valve leaks decrease stroke volume, therefore reducing aerobic performance, which is clear in my data.

I was just recommended a Cardiologist who is and Ironman triathlete and RAAM finisher. I am switching to him.

My goal is not to be able to compete, but to get back to my 2004 level.

QikSmurf

John979,


I can imagine the fear and stress you must be experiencing. Just know that the codition is curable and managable. Surgery is a last resort. The human heart has amazing adaptive ability to cope with stresses and load.

See what you Cardiologist says. If its affecting SV, then the chamber walls will be thicker and your heart may be enlarged. In these cases it is better to have the replacement surgery before your heart is damaged further.

Best of luck!

john979

Thanks. My enlargement is typical for an aerobic athlete, but does contribute to the situation, as over the last two years when training volume and particularly VO2 Max training was low, there was some recovery. Once training intensified, bam 20% power drop after about 20 months of steady gain.

samwedge

I had a crushing feeling on the left side of my chest that was quite painful. It turned out to be Tietzes Syndrome (Costochronditis) which is just an inflammation of the cartilage that connects the ribs to the sternum. It went away by itself after a few weeks.

Chest pain could be anything either coronary as john shows above or respitory such as pneumothorax (although if you're not struggling for breath then it's probably not a major pneumothorax, but still needs medical attention).

Go to see your doctor whether you trust them or not (or pop in to your chemist and describe your symptoms - there will be at least one medically trained member of staff there).

Good luck.

ClemmonsHoo

Definitely get this checked out. 3 years ago at age 45, I was training for a TT, and was in excellent shape, no symptoms of anything nefarious going on. Went out after work one evening for a hard ride, and BOOM! ended up on the side of the road with a massive heart attack after smoking everyone up a big hill. It is a miracle that I am here, and another miracle I have negligible heart damage, as my LAD was completely blocked by a dissection for 4 hours before my chest was cracked open and a bypass performed to save my life. Turns out I had a genetic condition called a myocardial bridge that just plain wore out the lining of my LAD under the loads I was putting on it. The moral of this is, it could be anything, and there are a certain number of people walking around with a ticking time bomb inside of them and do not know it. I am back riding again thankfully, but the Doc says I should not race anymore.

lmno609

It helps to be reminded of positive thoughts and positive attitudes. Get a small book of positive, inspirational thoughts and keep it by your desk. Read one or two thoughts each day.

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