I spent the latter half of the summer of 2018 chasing down heart problems. Motivated by a drop in max heart rate over the previous years, a corollary lack of performance, and stories of guys my age dropping dead, I curtailed all my high-intensity training and made an appointment with the MGH Cardio Performance Program. It can be tricky to debug heart issues with medical professionals. Unless they’re well versed in the physiology of endurance athletes, it can lead you down a rat hole.
The last time I tried to chase down similar issues was in the late 90’s, after I had retired from full-time racing. I was having trouble breathing, getting dizzy with hard efforts and overall having a difficult time adjusting to “civilian” life as a non-racer. I ended up on a treadmill in a doctor’s office in New York City, for a cardio stress test. The patient before me was in his 80’s and had needed help stepping on and off the treadmill. On the other hand, I was in my 20’s, and running so fast that the techs were getting concerned if their apparatus could handle the speed.
As soon as I hit my “peak” heart rate — I still had room to go higher but they were worried about the treadmill — they laid me down on an exam table and scanned my heart with an ultrasound device. Within 30 seconds my heart rate had returned to a normal rhythm and they were stuck. There hadn’t been enough time to really see much of what the heart was doing when it was working hard and the levels I had reached were far beyond what they would typically see. After a few moments, the tech said, “I think we figured it out! When you reach your max heart rate, it crashes. Like your heart can’t handle the workload.”
“Are you talking about the recovery once I’m on the table?” I asked.
“Yeah, as soon as you hit your max, it’s like your heart rate plummeted.”
“Isn’t it a sign of fitness that you can recover to your resting heart rate really quickly?”
The tech pondered a moment. “Um…yeah…you’re right.”
Eventually, I moved out of NYC, got more sleep and less alcohol, and the problems largely resolved.
But here I was again, many years and many miles later, wondering why my body didn’t seem up to the task. I had done plenty of exploration and analysis on my own. I had put together a list of hypotheses and was working through them one by one, as best I could.
- Getting old
- Weak/inefficient legs
- Poor base
- No high end
- Incomplete diet
- Undiagnosed heart problems
Part of the challenge was in isolating the variables and trying to control for them.