Heart Attack on the Race Course...

Some of you may remember because you were there, others may have read it here after the fact - during the June 2012 Ontario Criterium, start times for races in the late morning and in the afternoon were pushed back. I had heard rumors of a heart attack during one of the early races but never any official confirmation. Well, last week I received an email from a racer who was able to confirm the rumor, and thanked me for my concern. 

As it turned out that racer, Hugh Lothrop, did in fact suffer a heart attack during the Masters 55/60+ race and provided me with a little information about what happened. Mr. Lothrop related that after the first few laps he began to experience a burning pain in his chest, but shrugged it off, as most of us would, to a simple case of heart burn. He drank a little water and continued on. The pain persisted though, and in fact became more intense. He dropped back to the USAC official following the peloton on motorcycle and informed him of the pain he was experiencing. This was on the back side of the course. The official suggested he attempt to continue around to the start / finish were the first aid tent was located. He did not make it that far, collapsing unconscious within sight of the tent. Rushed to nearby San Antonio Hospital Mr. Lothrop underwent surgery for a completely blocked coronary artery.

But, this is a cautionary story, rather than one of woe. Within four weeks after the heart attack Hugh Lothrop was back running stairs, continued to improve and grow stronger, and has already raced twice this new season. 

In a follow-up to his initial email, I asked him if he would be willing to relate a little more about what happened, whether there were any warning signs, and about his recovery and progress over the past seven or so months. The following is his response which I am sharing verbatim:

"In retrospect there may have been warning signs. My doctors especially asked if I felt short of breath, but isn't that what happens when we race? I never felt any discomfort in the chest or anywhere else prior to the heart attack. At the district road championships I finished last and just couldn't push myself any harder, except for a guts out sprint at the end to stay ahead of the women's pack, hah. I have been racing on and off for more than 35 years, even raced in Europe, so I shouldn't finish last even in a grueling course like the Districts. I just thought I was having a bad day.  At Rosena Ranch on June 23rd I dropped out during the second lap after foolishly trying to bridge up to the madman doing a solo break. Again I attributed it to a bad move just before a pack acceleration. At Ontario on the 24th I warmed up for an hour, spinning and sprinting and felt fine. The pace during the race was well within my ability up until the chest pains. Going the lap and a half with the pain was a big mistake, but one can't blame me for thinking it something other than a heart attack. The real lapse on my part was thinking that moderately high serum cholesterol would be offset by a good diet and exercise. In my case, at least, it appears I should have been on statin drugs since my condition was identified more than a decade ago. Initially, after the heart attack I was put on 40 mg of atorvastatin and 80mg aspirin. That brought my total cholesterol down around 150, which is fine. I suppose each case is different and perhaps mine more unusual than most. While I may have had a complete blockage of my right coronary artery, my heart was very resilient from many years of conditioning. The doctors say my heart suffered almost no damage probably due to the rapid medical response (I don't have a good sense of time during the incident, but I must have been on the operating table in half an hour to 45 minutes). I did have a strange premonition about the race. I have never before put my doctor as the emergency contact, but she is a good friend and my wife was with her sister in Europe at the time. I almost asked my doctor's husband, also a doctor, to come to the race with me, but the early start meant getting him up quite early to get over from the Coachella Valley. I was released from the hospital in 2 days and driven home by a friend. I was a little uneasy staying alone at home the first few days (and nights), but in a week I began taking progressively longer and more vigorous walks, which restored my confidence. The third week I flew to join my wife in Europe and continued my daily walks. By the fourth week I was running stairs up a hill, at which time I decided I was going to start riding when I returned home. Since that time I have pushed myself progressively harder with no contraindications. Racing Ontario 1 [this year, 2013] was meant to be symbolic since that was where it all started back in June. I didn't feel stressed by the pace, but I thought it prudent to trail in at the back of the pack at the finish and call it a day. I still can't bring myself to push the limit, but it is just a matter of time until I regain full confidence.
Feel free to post this as a quote from me. It might remind us all of our mortality and appreciate our good fortune to be part of an elite group of athletes.
See you at the races :)"

I think Mr. Lothop's reaction to the events leading up to his heart attack are typical of what most of us would think and do. As athletes we tend to get used to aches and pains, they are part of the game. We minimize what might be signs of something more serious, shrug them off as insignificant, typical, due to being tired, pushed to the limit, normal for what we do many, maybe most days of the week. Maybe even more so as we grow older. After all, we are in good shape, have been racing for decades maybe. Most of the time our assessments prove true; cycling has made us stronger, more fit, more healthy. Of course, that does not mean we are immune to hidden conditions which may have been building for just as long as we have been racing. Or longer. Though it is up to each individual to judge what is best for themselves, we might want to give some extra consideration to those unusual aches and pains.

Thank you to Mr. Hugh Lothrop for sharing his story, and I dare say, for reminding us to appreciate our own good fortunes.