I don't think I've written about it before but I have been under going a "suspicious cardiac activity" investigation for about a month. My issue is nothing like IronJennys but it has been really nice to have a kindred soul sort of in the same boat while this was going on.

My situation was that I went for a physical on 9/7 and they did a quick EKG. The doctor saw a rhythm she said shows up in 1 of 2 places. Either in the ER while a person is having a heart attack or sometimes with athletes.

This heart thing is something I can feel, particularly after a race. My heart pounds in my chest much harder than normal and it sort of bothers me. After a couple of days the pounding goes away and I am not constantly aware of my heart beating in my chest. This has been happening for years.

She gave me a referral for some other tests and I picked 'athlete' as a cause and went on about my life including competing in 3 more events. During that time I had a 24 hour Holter test (where you wear a monitor for 24 hours and an echo cardiogram . No one called to tell me I should sit in a chair and wait for an ambulence so I didn't worry about it. Today I had a consultation with a cardiologist.

This guy was great. He explained in great detail how my pattern is just a mild idiosyncrasy of a normal patten (in fact it is called an idioventricular rhytm) and he told me how an athletic event would generate this pattern. He sat with a clipboard on his lap and drew this picture and wrote, upsidedown, as he gave me this explanation (click for larger image).

He dispelled some myths I had about the heart of an athlete pumping more blood because it is stronger or bigger. He said my heart is no stronger than any random 80 year olds (assuming they don't have heart disease). I'm not sure I really got what does make our heart rate lower but he referred to it as having better parasympathetic tone. That is, our hearts don't need to work as hard to deliver 02 because our parasympathetic system (which is chemical in nature) is stronger so our 02 delivery is more efficient. We have better parasympathetic tone because the training and racing elevate adreneline which elevates your heart rate and blood pressure. The parasympathetic system kicks in to lower it regardless of what you are doing. I guess the parasympathetic system is not sympathetic to your race - ha ha (that's a little lay person joke!). Anyhow, it seems that my parasympathetic system is still in high gear after the adreneline has calmed down so my ventrical assumes leadership for my heart beat instead of leaving it up to my atrial sinus. Okay so I took a little leap there but honestly - he didn't exactly fill in that gap. In any case, it all added up to me having a healthy heart so I'm good with that.

On the far right hand side of the page you see some more questions. He said my heart is perfect and healthy but my family history suggests that my arterial health needs some looking in to. It turns out that for women my age a heart attack is the leading cause of death and in 40% of the cases no one sees it coming. It also turns out that those garden variey cholesterol tests just aren't good enough. High HDL (which is good and which I have) is no asset if you lack a certain type of HDL (HDL-2). So I'm in for 2 more tests - a treadmill stress test which I have ALWAYS wanted to do (and sort of informally did when I had the Holter on by going running with it) and a more detailed cholesterol test called a VAP test. If those come back normal I will rejoice in my head to toe great health and continue to plan next year's race schedule. I have some ideas but since I'm not done yet this year (*sniffle*) I'm not quite ready to plan next year. Not even I know the answer to the question, "is there an Ironman in my future?"

Speaking of which - good luck to all the athletes in Kona!! The canon goes off in about 16 hours!